Pancho - CAM-JES-02

Code: CAM-JES-02
Mercy ID: V-01965-11
Encounter Date: 07/27/2005
Last: Campos
First: Jessica
DOB: 04/26/2002
County: Dekalb
Street: 6800 Peachtree Industrial B8
City: Atlanta
State: GA

Zip

30060-

Home

(770) 374-9187

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Veronica Rodriguez	01/30/1973	Mexico
Father	Felix Campos	08/31/1969	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