Pancho - BAR-NAT-08

Code: BAR-NAT-08
Mercy ID: V-03112-11
Encounter Date: 07/01/2009
Last: Barrientos
First: Natalie
DOB: 01/12/2008
County: Rockdale
Street: 952 Northridge Dr.
City: Conyers
State: GA

Zip

30012-

Cell

(678) 316-7539

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Magallanes	02/21/1976	Mexico
Father	Shoun Cunningham	04/02/1986	USA
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: YES

Intake: C. Martinez
Data Entry: J. Manzo