Pancho - WIL-JUL-02

Code: WIL-JUL-02
Mercy ID: V-01592-21
Encounter Date: 05/19/2004
Last: Wilhelm
First: Julian
DOB: 01/06/2002
County: Fulton
Street: 180 Jackson St. Apt K9
City: Atlanta
State: GA

Zip

30312-

Home

(404) 438-6754

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Jennifer Wilhelm	06/29/1972	USA
Father	Omar Angelito Mayo	06/22/1968	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: R. Miranda