Pancho - PAN-LEO-00

Code: PAN-LEO-00
Mercy ID: V-00877-21
Encounter Date: 03/27/2002
Last: Pantoja
First: Leonardo
DOB: 08/01/2000
County: Gwinnett
Street: 3594 Meadow Glen Apt. A
City: Doraville
State: GA

Zip

30340-

Home

(678) 937-9454

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	Norma Guzman	05/21/1976	Mexico
Father	Ruben Pantoja	08/27/1975	Mexico
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