Pancho - CHA-ANG-96

Code: CHA-ANG-96
Mercy ID: V-00684-24
Encounter Date: 09/19/2001
Last: Chavez
First: Angel
DOB: 12/20/1996
County: Cobb
Street: 3510 Buford Hwy Apt. W7
City: Atlanta
State: GA

Zip

30329-

Home

(678) 488-9405

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Silvia Castillo	03/18/1967	Guatemala
Father	Jose Chavez	07/25/1959	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: Y. Garcia
Data Entry: K. Aleman