Pancho - AVE-MIG-92

Code: AVE-MIG-92
Mercy ID: V-01708-23
Encounter Date: 06/15/2005
Last: Avellaneda
First: Miguel
DOB: 05/04/1992
County: Cobb
Street: 540 Mobile lane Way
City: Marietta
State: GA

Zip

30008-

Home

(678) 471-5234

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Guadalupe Avellaneda	05/06/1965	Mexico
Father	Miguel Angel Avellaneda	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Father
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