Pancho - RAM-BRI-04

Code: RAM-BRI-04
Mercy ID: V-02187-21
Encounter Date: 03/29/2006
Last: Ramirez sandoval
First: Brian
DOB: 08/06/2004
County: Dekalb
Street: 2235 Plaster Rd Apt #60
City: Atlanta
State: GA

Zip

30345-

Cell

(404) 396-2960

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Erika Sandoval Cervantes	04/23/1982	Mexico
Father	Ismael Ramirez	01/14/1981	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: R. Gonzalez
Data Entry: R. Gonzalez