Pancho - SOT-JOH-01

Code: SOT-JOH-01
Mercy ID: V-01067-23
Encounter Date: 01/08/2003
Last: Soto
First: John
DOB: 09/08/2001
County: Cobb
Street: 131 Appleton Cir
City: Marietta
State: GA

Zip

30008-

Cell

(404) 380-4145

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Marvella Macedo	01/11/1980	Mexico
Father	Jose Soto	11/06/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Fair Oaks
Grade: 2nd.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Y. Garcia
Data Entry: K. Aleman