Pancho - PIN-JUA-96

Code: PIN-JUA-96
Mercy ID: V-00269-24
Encounter Date: 08/23/2000
Last: Pineda
First: Juan
DOB: 06/21/1996
County: Cobb
Street: 5950 Garner Rd
City: Mableton
State: GA

Zip

30126-

Home

(678) 945-9515

Family Status

Attached youth

COB

Guatemala

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Reyna Orellana	12/08/1961	Guatemala
Father	Gilberto Pineda	04/06/1960	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
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: K. Aleman
Data Entry: D. Gomez