Pancho - MUR-JOR-94

Code: MUR-JOR-94
Mercy ID: V-01152-21
Encounter Date: 06/18/2003
Last: Murillo
First: Jorge
DOB: 12/22/1994
County: Dekalb
Street: 3600 Shallowford Rd. D7
City: Chamblee
State: GA

Zip

30341-

Home

(770) 912-8525

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Johana Vazquez	04/04/1972	Honduras
Father	Jorge Murillo	10/30/1966	Honduras
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Kary Reynolds
Grade: 3rd
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