Pancho - MON-ARI-08

Code: MON-ARI-08
Mercy ID: V-02792-21
Encounter Date: 10/15/2008
Last: Montes
First: Ariel
DOB: 08/09/2008
County: Cobb
Street: 1208 Station Club Drive
City: Marietta
State: GA

Zip

30066-0

Cell

(770) 912-1380

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Lucia Montes	03/15/1977	El Salvador
Father	Jose Canales	N/A	El Salvador
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: G. Landeros
Data Entry: J. Manzo