Pancho - HEN-CHR-08

Code: HEN-CHR-08
Mercy ID: V-03329-21
Encounter Date: 05/12/2010
Last: Henao
First: Christopher
DOB: 01/16/2008
County: Dekalb
Street: 3061 Oakcliff Rd. Apt. 115
City: Doraville
State: GA

Zip

30340-

Home

(770) 455-9774

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Post Grad Degree

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Lorena Gomez	01/18/1986	Colombia
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Montesuri school
Grade: Pre-K
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