Pancho - BUS-JUA-88

Code: BUS-JUA-88
Mercy ID: B-00044-21
Encounter Date: 03/17/1999
Last: Bustamante
First: Juan
DOB: 04/28/1988
County: Dekalb
Street: 7080 Northern Place Apt 40
City: Doraville
State: GA

Zip

30360-

Home

(770) 522-0960

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Ana Bustamante	02/21/1959	Ecuador
Father	Johny Bustamante	01/16/1962	Ecuador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: J. Manzo
Data Entry: K. Aleman