Pancho - VEL-MAR-94

Code: VEL-MAR-94
Mercy ID: V-00795-11
Encounter Date: 01/23/2002
Last: Velazquez
First: Marisol
DOB: 06/02/1994
County: Cobb
Street: 425 Lake Dr.
City: Marietta
State: GA

Zip

30060-

Home

(678) 290-9283

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Marisol Velazquez	02/07/1974	Mexico
Father	Roberto Palma	05/13/1969	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Parkstreet Elementary
Grade: 2nd.
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