Pancho - ALV-ALL-01

Code: ALV-ALL-01
Mercy ID: V-01424-21
Encounter Date: 12/03/2003
Last: Alvarez
First: Allen
DOB: 07/03/2001
County: Dekalb
Street: 3353 B Peachtree Corner Circle
City: Norcross
State: GA

Zip

30092-

Cell

(770) 895-5016

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	Adela Maya	06/17/1973	Mexico
Father	Simeon Alvarez	09/15/1970	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Peachtree Elem
Grade: 4th.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: YES

Intake: Y. Garcia
Data Entry: K. Aleman