Pancho - CAN-VIC-92

Code: CAN-VIC-92
Mercy ID: V-00743-21
Encounter Date: 11/14/2001
Last: Canelo
First: Victor
DOB: 07/13/1992
County: Dekalb
Street: 3124 Buford Hwy #48
City: Atlanta
State: GA

Zip

30329-

Home

(404) 315-4889

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Elena Moctezuma	11/07/1969	Mexico
Father	Sabino Canelo	04/23/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Woodward Elementary
Grade: 4th.
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