Pancho - CHA-FEL-90

Code: CHA-FEL-90
Mercy ID: V-03374-21
Encounter Date: 07/28/2010
Last: Chavez
First: Felipe
DOB: 10/26/1990
County: Dekalb
Street: 307 Briar Hill
City: Atlanta
State: GA

Zip

30324-

Home

(678) 887-6845

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	Maricela De Castañon	12/25/1970	Mexico
Father	Felipe Chavez	06/19/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: mom
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: J. Manzo