Pancho - POP-ANG-02

Code: POP-ANG-02
Mercy ID: V-02113-12
Encounter Date: 05/31/2006
Last: Popoca
First: Angelica
DOB: 09/01/2004
County: Gwinnett
Street: 2906 Spruce Cirlcle
City: Snellville
State: GA

Zip

30078-

Home

(678) 760-2813

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Crystal Masterson	06/07/1982	USA
Father	Jose Angel Popoca	08/01/1984	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: R. Gonzalez
Data Entry: R. Gonzalez