Pancho - REY-LEO-03

Code: REY-LEO-03
Mercy ID: V-01557-21
Encounter Date: 05/26/2004
Last: Reyes
First: Leonel jr
DOB: 07/29/2003
County: Fulton
Street: 3072 Washington Rd. #E4
City: East point
State: GA

Zip

30344-

Home

(404) 209-9839

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	Maria Preciado	08/27/1971	Mexico
Father	Leonel Reyes	11/16/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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