Pancho - ANT-ALE-07

Code: ANT-ALE-07
Mercy ID: V-02435-25
Encounter Date: 07/18/2007
Last: Antonio
First: Alexis
DOB: 03/01/2007
County: Dekalb
Street: 3160 Buford Hwy. I-2
City: Atlanta
State: GA

Zip

30329-

Cell

(678) 858-0730

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Celia Herrera	01/20/1968	Mexico
Father	Martin Antonio	07/18/1978	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: G. Landeros
Data Entry: J. Manzo