Pancho - BAI-NEL-05

Code: BAI-NEL-05
Mercy ID: V-03343-13
Encounter Date: 06/16/2010
Last: Bailon
First: Nelly
DOB: 05/26/2005
County: Dekalb
Street: 2285 Plaster Rd. Apt. 7
City: Atlanta
State: GA

Zip

30345-

Cell

(678) 237-6622

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Nelida Baltazar	10/31/1978	Mexico
Father	Filemon Bailon	12/17/1974	Mexico
Step Parent	N/A	N/A	N/A

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

Intake: C. Martinez
Data Entry: J. Manzo