Pancho - RAM-JAI-95

Code: RAM-JAI-95
Mercy ID: V-00011-22
Encounter Date: 01/05/2000
Last: Ramirez
First: Jaime
DOB: 09/10/1995
County: Gwinnett
Street: 1312 Stoney Brook Dr
City: Tucker
State: GA

Zip

30084-

Home

(770) 496-4558

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Rafaela Camacho	02/06/1962	Mexico
Father	Ernesto Ramirez	03/06/1970	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: J. Manzo
Data Entry: D. Gomez