Pancho - SAN-ESB-00

Code: SAN-ESB-00
Mercy ID: V-00318-12
Encounter Date: 10/27/2000
Last: Santana
First: Esbelda
DOB: 03/31/2000
County: Rockdale
Street: 3390 Quinn Ridge Dr.
City: Snellvile
State: GA

Zip

30039-

Cell

(678) 349-8063

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Norma Segura	01/04/1960	Mexico
Father	Pablo Santana	07/07/1954	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 4th.
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: K. Aleman
Data Entry: S. Aviña