Pancho - PEÑ-JOY-05

Code: PEÑ-JOY-05
Mercy ID: V-02464-21
Encounter Date: 04/11/2007
Last: Peña
First: Johnny
DOB: 09/20/2005
County: Fulton
Street: 316 Good Creek Ct.
City: Roswell
State: GA

Zip

30076-

Home

(678) 651-6817

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Romeli Bazan	11/21/1982	Mexico
Father	N/A	N/A	N/A
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: J. Manzo