Pancho - SAL-LUI-98

Code: SAL-LUI-98
Mercy ID: V-02014-22
Encounter Date: 04/12/2006
Last: Salazar
First: Luis fernando
DOB: 08/28/1998
County: Dekalb
Street: 3612 Morning Size Vella
City: Doraville
State: GA

Zip

30340-

Home

(678) 458-1909

Cell

(678) 508-9897

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Blanca Flores	08/14/1972	Mexico
Father	Fernando Salazar	08/12/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Pleasantdale
Grade: 2nd.
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: R. Gonzalez
Data Entry: R. Gonzalez