Pancho - MON-KEV-01

Code: MON-KEV-01
Mercy ID: V-01355-22
Encounter Date: 09/24/2003
Last: Monsalvo
First: Kevin
DOB: 10/10/2001
County: Dekalb
Street: 6493 Pleasantdale Rd. #1
City: Doraville
State: GA

Zip

30340-

Home

(770) 559-4500

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Other

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Nora Monsalvo	01/02/1965	Mexico
Father	David Monsalvo	09/14/1964	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