Pancho - ESP-AMY-98

Code: ESP-AMY-98
Mercy ID: V-00121-12
Encounter Date: 03/01/2000
Last: Espinoza
First: Amy
DOB: 07/14/1998
County: Other
Street: 4486 Cherokee Dr. Lt. 58
City: Douglasville
State: GA

Zip

30134-

Home

(678) 838-9394

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alma Hernandez	02/28/1976	Mexico
Father	Octavio Espinosa	07/18/1972	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: J. Perez
Data Entry: Y. Garcia