Pancho - BAL-TAN-86

Code: BAL-TAN-86
Mercy ID: V-00680-11
Encounter Date: 09/19/2001
Last: Balderas
First: Tania
DOB: 07/27/1986
County: Cobb
Street: 2401 Windy Hill
City: Marietta
State: GA

Zip

30067-

Home

(770) 226-0894

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria Hernandez	04/07/1968	Mexico
Father	Alberto Padron	01/03/1968	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: East Cobb High School
Grade: 9th.
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: Y. Garcia
Data Entry: K. Aleman