Pancho - ZAM-LAN-03

Code: ZAM-LAN-03
Mercy ID: V-01823-22
Encounter Date: 02/02/2005
Last: Zamarripa
First: Landon
DOB: 06/02/2003
County: Dekalb
Street: 3160 Buford Hwy Apt H3
City: Atlanta
State: GA

Zip

30329-

Home

(678) 755-5312

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	Tania Carrasco	03/28/1980	Mexico
Father	Fernando Zamarripa	06/01/1979	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