Pancho - GAR-ANS-97

Code: GAR-ANS-97
Mercy ID: V-00249-11
Encounter Date: 07/19/2000
Last: Garcia
First: Ansly
DOB: 11/19/1997
County: Dekalb
Street: 2234 Plaster Rd. Apt. c
City: Atlanta
State: GA

Zip

30345-

Home

(404) 633-2133

Family Status

Attached 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 Hernandez	01/17/1969	Mexico
Father	Oscar Garcia	07/19/1974	Mexico
Step Parent	N/A	N/A	N/A

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