Pancho - PER-STE-90

Code: PER-STE-90
Mercy ID: V-01116-11
Encounter Date: 02/19/2003
Last: Pereira
First: Stephanie
DOB: 06/26/1990
County: Dekalb
Street: 2813 Belaire Circle
City: Doraville
State: GA

Zip

30340-

Home

(678) 547-0626

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Janet Mantilla	02/01/1966	Mexico
Father	Jose Luis Pereira	12/13/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Sequoyah Middle
Grade: 7th.
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