Pancho - ESP-AND-95

Code: ESP-AND-95
Mercy ID: V-00121-14
Encounter Date: 07/16/2003
Last: Espinoza
First: Andrea
DOB: 06/11/1995
County: Other
Street: 2390 Fairburn Rd. Lot 49
City: Douglasville
State: GA

Zip

30135-

Home

(678) 838-9394

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	Melina Goerte	N/A	Mexico
Father	Octavio Espinoza	07/18/1972	Mexico
Step Parent	Alma Espinoza	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Father w/Stepmother
Name of School: N/A
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: Y. Garcia
Data Entry: K. Aleman