Pancho - WIL-RAN-95

Code: WIL-RAN-95
Mercy ID: V-00113-21
Encounter Date: 03/22/2000
Last: Wilson
First: Randall
DOB: 06/04/1995
County: Cobb
Street: 768 roger way
City: Marietta
State: GA

Zip

30064-

Home

(678) 290-1243

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	martha wilson	02/28/1958	Perú
Father	randall wilson	08/08/1959	EEUU
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: kiddy college
Grade: Pre-K
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: K. Aleman
Data Entry: S. Aviña