Pancho - DEL-EDU-02

Code: DEL-EDU-02
Mercy ID: V-03501-22
Encounter Date: 01/19/2011
Last: De leon
First: Eduardo
DOB: 09/04/2002
County: Dekalb
Street: 938 Brook View
City: Doraville
State: GA

Zip

30340-

Cell

(404) 292-1075

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	Sofia mayorga	09/09/1980	Mexico
Father	Cesar E. de Leon	07/04/1977	Mexico
Step Parent	Miguel Angel Lopez	03/23/1987	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Pleasandale Elem 2
Grade: 2nd.
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