Pancho - ART-AMA-98

Code: ART-AMA-98
Mercy ID: B-00009-01
Encounter Date: 02/11/1998
Last: Artiaga
First: Amalia
DOB: 07/10/1998
County: Dekalb
Street: 2945 N. Dekalb Dr.
City: Doraville
State: GA

Zip

30340-

Home

(000) 000-0000

Family Status

Unknow/Unreported

COB

Mexico

Gender

Female Child

Housing

Other

Education Level

Vocational/Technical

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: K. Aleman