Pancho - ELV-DAR-09

Code: ELV-DAR-09
Mercy ID: V-03384-12
Encounter Date: 08/04/2010
Last: Elvir
First: Dailine
DOB: 01/02/2009
County: Dekalb
Street: 3201 Henderson Mill Rd. Apt. 21-C
City: Atlanta
State: GA

Zip

30341-

Cell

(404) 399-9541

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria Saavedra	08/17/1982	Mexico
Father	Darwin Alonso Elvir	04/04/1986	Honduras
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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: J. Manzo