Pancho - CAR-ROL-03

Code: CAR-ROL-03
Mercy ID: V-01755-22
Encounter Date: 11/17/2004
Last: Cardona
First: Rolando
DOB: 01/08/2003
County: Gwinnett
Street: 1391 Redington Ln.
City: Norcross
State: GA

Zip

30093-

Home

(678) 380-0400

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	Elvira Cano	02/04/1978	Mexico
Father	Ricardo Cardona	08/05/1976	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: K. Aleman
Data Entry: K. Aleman