Pancho - JOH-ROB-03

Code: JOH-ROB-03
Mercy ID: V-01664-22
Encounter Date: 08/11/2004
Last: Johnson
First: Robert
DOB: 01/16/2003
County: Clayton
Street: P.O. Box 870386
City: Morrow
State: GA

Zip

30287-

Home

(770) 961-7233

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Shelter

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Laura Robles/Johnson	01/01/1977	Mexico
Father	Robert Johnson	05/25/1965	USA
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