Pancho - DIA-DIA-98

Code: DIA-DIA-98
Mercy ID: V-01568-11
Encounter Date: 04/14/2004
Last: Diaz
First: Diana
DOB: 07/31/1998
County: Gwinnett
Street: 517 Fire Fly Dr.
City: Tucker
State: GA

Zip

30084-

Home

(678) 924-1961

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Sandra Polanco	06/14/1973	El Salvador
Father	Antonio Diaz	08/14/1976	Honduras
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Arcado Elementary
Grade: Kinder
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