Pancho - BUE-LEO-67

Code: BUE-LEO-67
Mercy ID: V-00017-02
Encounter Date: 02/02/2000
Last: Buenaventura
First: Leonardo
DOB: 08/22/1967
County: Dekalb
Street: 4745 Buford Hwy Apt. C
City: Chamblee
State: GA

Zip

30341-

Home

(678) 547-0850

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: F. Perez
Data Entry: K. Aleman