Pancho - GAR-LES-11

Code: GAR-LES-11
Mercy ID: V-00451-11
Encounter Date: 04/04/2001
Last: Garcia
First: Leslie
DOB: 05/23/1997
County: Fulton
Street: 1339 apt-b gran crique dr
City: Roswell
State: GA

Zip

30076-

Home

(770) 642-5575

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	josefa uriostegui	07/20/1976	Mexico
Father	daniel garcia	07/24/1974	Mexico
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: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: K. Aleman
Data Entry: S. Aviña