Pancho - ROB-YAN-01

Code: ROB-YAN-01
Mercy ID: V-01402-22
Encounter Date: 11/05/2003
Last: Roblero
First: Yaniv
DOB: 02/25/2001
County: Dekalb
Street: 3216 Chamblee Dunwoody Rd. #D
City: Chamblee
State: GA

Zip

30341-

Home

(770) 452-8908

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	Marina Lopez	12/26/1977	Guatemala
Father	Felipe Roblero	05/26/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: K. Aleman
Data Entry: K. Aleman