Pancho - MAR-SAL-98

Code: MAR-SAL-98
Mercy ID: V-01190-21
Encounter Date: 04/16/2003
Last: Martinez
First: Salvador
DOB: 12/17/1998
County: Dekalb
Street: 3319 Oakcliff Rd.
City: Doraville
State: GA

Zip

30340-

Home

(678) 908-3949

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Florencia Zepeda	11/12/1972	Mexico
Father	Dali Gandhi Martinez	02/10/1970	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