Pancho - HER-ISS-00

Code: HER-ISS-00
Mercy ID: V-01536-22
Encounter Date: 03/24/2004
Last: Hernandez
First: Issai
DOB: 06/11/2000
County: Gwinnett
Street: 5545 Bowers Rd .
City: Stone mountain
State: GA

Zip

30087-

Home

(404) 512-7315

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	Laura Camacho	02/13/1972	Mexico
Father	Jose Luis Hernandez	06/13/1968	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: Volunteer
Data Entry: K. Aleman