Pancho - MIL-LAN-01

Code: MIL-LAN-01
Mercy ID: V-02756-21
Encounter Date: 07/02/2008
Last: Millan
First: Jose
DOB: 03/18/2001
County: Fulton
Street: 2205 Sandalwood Dr. Apt. 2205
City: Atlanta
State: GA

Zip

30350-

Cell

(770) 572-1764

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Korina Alonzo	08/08/1984	Mexico
Father	Alfredo Millan	01/11/1983	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Dunwoody Spring
Grade: Kinder
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