Pancho - VAS-REY-96

Code: VAS-REY-96
Mercy ID: V-00187-21
Encounter Date: 07/05/2000
Last: Vasquez
First: Reymundo
DOB: 04/15/1996
County: Fulton
Street: 201 Northwood Dr
City: Atlanta
State: GA

Zip

30342-

Home

(404) 303-1505

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Eriselda Vasquez	03/15/1979	Mexico
Father	Gildardo Chavez	06/08/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: K. Aleman
Data Entry: D. Gomez