Pancho - BUI-MAR-99

Code: BUI-MAR-99
Mercy ID: V-01276-11
Encounter Date: 10/08/2003
Last: Buitron
First: Marisol
DOB: 08/19/1999
County: Fulton
Street: 3315 Roswell Rd. #15
City: Atlanta
State: GA

Zip

30305-

Home

(404) 869-4438

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	Matea Salazar	01/24/1970	Mexico
Father	Estevan Buitron	09/12/1975	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