Pancho - PER-LEO-07

Code: PER-LEO-07
Mercy ID: V-02172-22
Encounter Date: 02/11/2008
Last: Perez
First: Leonardo
DOB: 09/17/2007
County: Cobb
Street: 1245 Brand Dr. SW
City: Marietta
State: GA

Zip

30008-

Cell

(678) 334-6660

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Esmerald Silva	03/17/1975	Mexico
Father	Mauricio Perez	05/05/1973	Mexico
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: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo