Pancho - HAL-JAS-96

Code: HAL-JAS-96
Mercy ID: V-03171-21
Encounter Date: 09/30/2009
Last: Hall
First: Jason
DOB: 06/07/1996
County: Cobb
Street: 204 Timber Creek Ln
City: Marietta
State: GA

Zip

30060-

Cell

(678) 274-2321

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	isela E. Ordoñes	03/01/1977	Mexico
Father	Jason Hall	10/03/1967	USA
Step Parent	Juan Antonio Ordoñes	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Floyd Middle School
Grade: 8th.
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