Pancho - LEE-LOU-01

Code: LEE-LOU-01
Mercy ID: V-01523-21
Encounter Date: 03/17/2004
Last: Lee
First: Louise
DOB: 08/10/2001
County: Dekalb
Street: 3128 Briarcliff Rd. Apt A
City: Atlanta
State: GA

Zip

30329-

Home

(404) 728-1112

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	Angelica Montante	11/07/1981	Mexico
Father	Luis Lee Rodriguez	03/24/1962	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