Pancho - ZUÑ-JAC-98

Code: ZUÑ-JAC-98
Mercy ID: V-00766-11
Encounter Date: 01/23/2002
Last: Zuñiga
First: Jackelyn
DOB: 08/28/1998
County: Other
Street: 6942 Spring Wood Dr.
City: Douglassville
State: GA

Zip

30135-

Home

(404) 667-0490

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Katherine A. Gaitan	09/30/1978	USA
Father	Estevan Zuñiga	10/11/1978	Mexico
Step Parent	Jhonny Quiñones	10/21/1973	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
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: Y. Garcia
Data Entry: K. Aleman