Pancho - TOR-DAN-03

Code: TOR-DAN-03
Mercy ID: V-01940-23
Encounter Date: 06/22/2005
Last: Toribio
First: Daniel tenoch
DOB: 01/29/2003
County: Cobb
Street: 3222 Oakwood Lane
City: Atlanta
State: GA

Zip

30341-

Cell

(404) 246-2139

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Transitional

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Karla Toribio	12/07/1976	Mexico
Father	Pedro Toribio	12/23/1973	Dominican Rep
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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