Pancho - SIE-DYL-00

Code: SIE-DYL-00
Mercy ID: V-00745-23
Encounter Date: 04/17/2002
Last: Sierra
First: Dylan
DOB: 06/27/2000
County: Dekalb
Street: 3610 Buford Hwy
City: Atlanta
State: GA

Zip

30329-

Home

(404) 634-1438

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Gloria Cano	09/24/1962	Mexico
Father	Crisanto Sierra	10/25/1960	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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