Pancho - MAL-AND-05

Code: MAL-AND-05
Mercy ID: V-02115-21
Encounter Date: 12/21/2005
Last: Maldonado
First: Andy
DOB: 05/08/2005
County: Fulton
Street: 4203 Buford Hwy
City: Atlanta
State: GA

Zip

30345-

Cell

(678) 549-2605

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Blanca Ramos	01/22/1982	Honduras
Father	Dionisio Maldonado	10/21/1978	Honduras
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: Volunteer
Data Entry: R. Gonzalez