Pancho - BEL-JON-89

Code: BEL-JON-89
Mercy ID: V-00753-21
Encounter Date: 12/05/2001
Last: Beltran
First: Jonathan
DOB: 08/12/1989
County: Gwinnett
Street: 772 River Landing Dr.
City: Lawrenceville
State: GA

Zip

30045-

Home

(770) 682-8853

Family Status

Attached youth

COB

Puerto Rico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Belinda Rivera	04/20/1964	Puerto Rico
Father	Francisco J. Beltran	N/A	Puerto Rico
Step Parent	Cesar Muñoz	03/25/1963	Perú

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Sweet Water Middle
Grade: 7th.
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