Pancho - BRO-NAT-99

Code: BRO-NAT-99
Mercy ID: V-01011-11
Encounter Date: 09/11/2002
Last: Brocks
First: Nathalie
DOB: 10/18/1999
County: Clayton
Street: 791 River Band Dr.
City: Jonesboro
State: GA

Zip

30238-

Home

(770) 719-8748

Family Status

Attached youth

COB

Venezuela

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria E. Brocks	07/22/1971	Venezuela
Father	Alex Brocks	03/17/1973	Venezuela
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: Y. Garcia
Data Entry: K. Aleman