Pancho - CIS-JON-95

Code: CIS-JON-95
Mercy ID: V-02688-22
Encounter Date: 01/30/2008
Last: Cisneros
First: Jonathan
DOB: 03/10/1995
County: Clayton
Street: 905 White Oak Trail
City: Jonesboro
State: GA

Zip

30238-

Cell

(404) 552-4106

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Gabriela Arteaga	03/29/1970	Mexico
Father	Juan Jose Cisneros	09/28/1965	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Lovejoy M.S.
Grade: 7th.
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