Pancho - CON-MAR-94

Code: CON-MAR-94
Mercy ID: V-03534-11
Encounter Date: 03/02/2011
Last: Contreras
First: Maria guadalupe
DOB: 08/10/1994
County: Fulton
Street: 3034 Washington Rd. Apt. 6
City: East point
State: GA

Zip

30344-

Cell

(678) 235-1576

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Single Family

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Lourdes Cardenas	08/10/1978	Mexico
Father	Jose Luis Contreras	05/25/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Tray City High S.
Grade: 11th.
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