Pancho - NAV-JAV-01

Code: NAV-JAV-01
Mercy ID: V-01422-21
Encounter Date: 11/19/2003
Last: Nava
First: Javier
DOB: 01/03/2001
County: Dekalb
Street: Aztec RD. Apt 42
City: Doraville
State: GA

Zip

30341-

Home

(770) 986-4118

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Araceli Olvera	10/17/1981	Mexico
Father	Luis Nava	02/06/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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