Pancho - JUR-ADA-01

Code: JUR-ADA-01
Mercy ID: V-03446-21
Encounter Date: 10/06/2010
Last: Jurado
First: Adan
DOB: 09/26/2001
County: Dekalb
Street: 3180 Clairmont Rd.
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 909-7398

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Graciela Padilla	07/26/1977	Mexico
Father	Luciano Jurado	06/30/1964	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Montclair elem
Grade: 3rd.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo