Pancho - VIL-CAR-95

Code: VIL-CAR-95
Mercy ID: V-00665-22
Encounter Date: 10/17/2001
Last: Villanueva
First: Carlos
DOB: 02/24/1995
County: Dekalb
Street: 1103 Winter Chapel
City: Doraville
State: GA

Zip

30341-

Home

(404) 663-5652

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Veronica Villanueva	01/03/1973	Mexico
Father	Antonio Lezo	10/07/1973	Mexico
Step Parent	N/A	N/A	N/A

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