Pancho - LEO-BRA-02

Code: LEO-BRA-02
Mercy ID: V-00636-22
Encounter Date: 01/07/2005
Last: Leon
First: Brayon
DOB: 04/09/2002
County: Gwinnett
Street: 2290 Heatherton Circle
City: Dacula
State: GA

Zip

30019-

Home

(770) 962-1286

Family Status

Attached youth

COB

Colombia

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maritza Martinez (Leon)	04/16/1973	Colombia
Father	Jose Leon	09/03/1962	Colombia
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