Pancho - VEL-CHR-01

Code: VEL-CHR-01
Mercy ID: V-01462-21
Encounter Date: 01/07/2004
Last: Velazquez
First: Christian
DOB: 03/11/2001
County: Dekalb
Street: 1605 Briarwood Rd.
City: Atlanta
State: GA

Zip

30319-

Home

(678) 760-6817

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	Maricela Velazquez	09/13/1979	Mexico
Father	Jorge Marin	04/15/1973	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