Pancho - SAM-LET-95

Code: SAM-LET-95
Mercy ID: V-01744-11
Encounter Date: 12/01/2004
Last: Samano martinez
First: Leticia
DOB: 07/08/1995
County: Fulton
Street: 7000 Roswell Rd.
City: Atlanta
State: GA

Zip

30328-

Home

(404) 483-7451

Cell

(770) 698-9633

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Rita Samano	07/09/1975	Mexico
Father	Antonio Martinez	05/28/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Spallen Dr. Elementary
Grade: 3rd.
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: Volunteer
Data Entry: R. Miranda