Pancho - REY-JOS-00

Code: REY-JOS-00
Mercy ID: V-01893-22
Encounter Date: 10/26/2005
Last: Reyes
First: Jose jr
DOB: 09/14/2000
County: Gwinnett
Street: 702 Gwinnett Square Circle
City: Duluth
State: GA

Zip

30096-

Home

(770) 209-6658

Cell

(404) 319-5698

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	Marisol Zapata	07/13/1979	Mexico
Father	Jose Reyes	04/05/1969	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Charols Brand Chestuy
Grade: Pre-K
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: C. Martinez
Data Entry: R. Gonzalez