Pancho - VAZ-TAN-98

Code: VAZ-TAN-98
Mercy ID: V-00537-11
Encounter Date: 06/27/2001
Last: Vazquez
First: Tania
DOB: 11/14/1998
County: Dekalb
Street: 4900 Central Dr. Apt. 159
City: Stone mountain
State: GA

Zip

30083-

Home

(770) 469-8194

Family Status

Attached youth

COB

Nicaragua

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Ninoska Vazquez	12/05/1977	Nicaragua
Father	Adolfo Aviles	N/A	Nicaragua
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: K. Aleman
Data Entry: K. Aleman