Pancho - CER-JOS-98

Code: CER-JOS-98
Mercy ID: V-00421-11
Encounter Date: 03/07/2001
Last: Cervantes
First: Joselenia
DOB: 04/19/1998
County: Dekalb
Street: 4969 Central Way Apt. 204-A
City: Stone mountain
State: GA

Zip

30083-

Home

(770) 413-1749

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Mayra Gomez	10/17/1975	Guatemala
Father	Sergio Cervantes	10/07/1961	Guatemala
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: K. Aleman
Data Entry: K. Aleman