Pancho - MUÑ-DAN-00

Code: MUÑ-DAN-00
Mercy ID: V-02923-21
Encounter Date: 10/22/2008
Last: Muñoz
First: Daniel
DOB: 01/14/2000
County: Fulton
Street: 683 Britt Rd. SW
City: Mableton
State: GA

Zip

30126-

Cell

(404) 625-4579

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	Marisol Ayala	07/06/1970	Mexico
Father	Toma Muñoz	08/30/1970	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Riverside Elem
Grade: 3rd.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: F. Gomez
Data Entry: J. Manzo