Pancho - VEL-CHR-98

Code: VEL-CHR-98
Mercy ID: V-00795-22
Encounter Date: 01/23/2002
Last: Velazquez
First: Christopher
DOB: 11/26/1998
County: Cobb
Street: 425 Lake Dr.
City: Marietta
State: GA

Zip

30060-

Home

(678) 290-9288

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Marisol Velazquez	02/07/1974	Mexico
Father	Roberto Palma	05/13/1969	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: Y. Garcia
Data Entry: K. Aleman