Pancho - OLI-SAM-88

Code: OLI-SAM-88
Mercy ID: V-00640-21
Encounter Date: 05/14/2002
Last: Olivares
First: Samuel jr
DOB: 07/31/1988
County: Gwinnett
Street: 81258 McPherson Lane #A
City: Norcross
State: GA

Zip

30093-

Home

(770) 582-1078

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alejandra Delgado	05/03/1968	Mexico
Father	Samuel Olivares	08/20/1969	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Middle School
Grade: 6th.
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