Pancho - DIM-FID-02

Code: DIM-FID-02
Mercy ID: V-01386-21
Encounter Date: 10/15/2003
Last: Dimas
First: Fidel
DOB: 01/23/2002
County: Fulton
Street: 2787 Sheney St.
City: East point
State: GA

Zip

30344-

Home

(678) 755-9491

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	Brandie Fowler	01/23/1982	USA
Father	Fidel Dimas	04/15/1978	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