Pancho - VIC-BRE-99

Code: VIC-BRE-99
Mercy ID: V-00029-12
Encounter Date: 01/05/2000
Last: Vicente
First: Brenda
DOB: 07/05/1999
County: Cherokee
Street: 310 Keith Dr Apt-7
City: Canton
State: GA

Zip

30114-2881

Family Status

Attached youth

COB

Guatemala

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Matias	01/27/1969	Guatemala
Father	Margarito Vicente	07/20/1957	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: J. Manzo
Data Entry: D. Gomez