Pancho - CAR-JES-05

Code: CAR-JES-05
Mercy ID: V-01941-21
Encounter Date: 11/30/2005
Last: Cardiel
First: Jesus
DOB: 01/29/2005
County: Fulton
Street: 1635 Oak Field Lane
City: Roswell
State: GA

Zip

30075-

Home

(770) 643-9648

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Veronica Camargo	04/06/1977	Mexico
Father	Jesus Cardiel	03/13/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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. Gonzalez