Pancho - VEL-STE-96

Code: VEL-STE-96
Mercy ID: V-00795-21
Encounter Date: 01/23/2002
Last: Velazquez
First: Stephen
DOB: 04/29/1996
County: Cobb
Street: 425 Lake Dr.
City: Marietta
State: GA

Zip

30060-

Home

(678) 290-9283

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Marisol Velazquez	02/07/1974	Mexico
Father	Roberto Palma	05/13/1969	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Parkstreet Elementary
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