Pancho - MON-JON-02

Code: MON-JON-02
Mercy ID: V-01915-21
Encounter Date: 06/01/2005
Last: Montufar
First: Jonathan
DOB: 12/26/2002
County: Fulton
Street: 20 Long St.
City: East point
State: GA

Zip

30344-

Home

(404) 468-2746

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria Montufar	01/28/1985	Mexico
Father	N/A	N/A	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: Volunteer
Data Entry: K. Aleman