Pancho - DEL-MAR-99

Code: DEL-MAR-99
Mercy ID: V-00024-21
Encounter Date: 03/22/2000
Last: Del valle
First: Marc anthony
DOB: 08/24/1999
County: Fulton
Street: 6945 Roswell Rd Apt- F
City: Atlanta
State: GA

Zip

30328-

Home

(770) 913-0181

Family Status

Attached youth

COB

El Salvador

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Rosa Lazo	08/17/1976	El Salvador
Father	Juan Miguel Del Valle	09/29/1979	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: K. Aleman
Data Entry: D. Gomez