Pancho - VIL-KEV-08

Code: VIL-KEV-08
Mercy ID: V-03072-22
Encounter Date: 05/13/2009
Last: Villalobos
First: Kevin
DOB: 06/26/2008
County: Clayton
Street: 6355 Valley Dale
City: Riverdale
State: GA

Zip

30274-

Cell

(678) 368-6568

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Yesenia Barajas	02/07/1980	Mexico
Father	Hugo Villalobos	05/20/1980	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: C. Martinez
Data Entry: J. Manzo