Pancho - QUE-MAR-00

Code: QUE-MAR-00
Mercy ID: V-00983-11
Encounter Date: 08/14/2002
Last: Quezada
First: Mary
DOB: 10/20/2000
County: Gwinnett
Street: 2213 Tahoe Ct.
City: Norcross
State: GA

Zip

30071-

Home

(770) 449-7082

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Sandra Lucio	12/26/1978	Mexico
Father	Rodolfo Quezada	05/25/1977	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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