Pancho - FRA-ANA-00

Code: FRA-ANA-00
Mercy ID: V-01308-11
Encounter Date: 08/07/2003
Last: Fragoso
First: Ana
DOB: 10/07/2000
County: Dekalb
Street: 3574 Buford Hwy Apt4
City: Atlanta
State: GA

Zip

30329-

Home

(404) 325-5796

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	Lourdes Varela	02/11/1974	Mexico
Father	Ricardo Fragoso	04/03/1973	Mexico
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