Pancho - SER-JOS-01

Code: SER-JOS-01
Mercy ID: V-00742-21
Encounter Date: 11/14/2001
Last: Serrano
First: Jose
DOB: 05/20/2001
County: Dekalb
Street: 548 South Wing Dr.
City: Lilburn
State: GA

Zip

30347-

Home

(770) 279-7139

Family Status

Attached youth

COB

El Salvador

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Vicky Serrano	03/17/1966	El Salvador
Father	Jose D. Serrano	07/15/1965	El Salvador
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: Y. Garcia
Data Entry: K. Aleman