Pancho - VER-MAR-87

Code: VER-MAR-87
Mercy ID: V-01057-21
Encounter Date: 01/08/2003
Last: Vera
First: Mario
DOB: 01/25/1987
County: Fulton
Street: 6115 Abbotts Bridge Rd.
City: Duluth
State: GA

Zip

30097-

Home

(770) 232-7514

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Hernandez	04/28/1964	Mexico
Father	Mario Vera	12/02/1962	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 9th.
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