Pancho - GAL-JOS-94

Code: GAL-JOS-94
Mercy ID: V-01947-21
Encounter Date: 06/29/2005
Last: Gallegos
First: Jose
DOB: 05/10/1994
County: Dekalb
Street: not given
City: Not given
State: GA

Zip

N/A

Home

(404) 297-5753

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Shelter

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Araceli Gallegos	05/07/1976	Mexico
Father	Jose D. Gallegos	04/09/1965	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 6th.
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