Pancho - COB-JAI-97

Code: COB-JAI-97
Mercy ID: V-02562-21
Encounter Date: 12/10/2008
Last: Cobos
First: Jair
DOB: 12/24/1997
County: Fulton
Street: 5555 Roswell Road Apt. B-6
City: Sandy springs
State: GA

Zip

30342-

Cell

(404) 993-6145

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Norma Cobos	09/24/1971	Mexico
Father	Jose Teledano	08/22/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Lake Forest Elem.
Grade: 5th.
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: C. Martinez
Data Entry: J. Manzo