Pancho - PAL-LUI-99

Code: PAL-LUI-99
Mercy ID: V-01708-21
Encounter Date: 12/01/2004
Last: Palazuelos
First: Luis david
DOB: 02/08/1999
County: Cobb
Street: 540 Mobile Lane
City: Marietta
State: GA

Zip

30008-

Home

(678) 471-5234

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Guadalupe Avellaneda	05/06/1965	Mexico
Father	Luis Palazuelos	N/A	Mexico
Step Parent	Arcadio Calles	10/06/1976	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Farrets
Grade: Kinder
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: K. Aleman
Data Entry: K. Aleman