Pancho - RAM-JAS-93

Code: RAM-JAS-93
Mercy ID: V-02935-22
Encounter Date: 11/12/2008
Last: Ramos
First: Jason
DOB: 09/04/1993
County: Gwinnett
Street: 310 Rebeca St.
City: Lawrenceville
State: GA

Zip

30045-

Cell

(678) 327-6754

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

some high school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	laura Revillat	12/01/1966	El Salvador
Father	Juan Jose	05/07/1966	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Central Gwinnett H.S.
Grade: 9th.
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