Pancho - AGU-IVA-99

Code: AGU-IVA-99
Mercy ID: V-00337-21
Encounter Date: 01/31/2000
Last: Aguilar
First: Ivan
DOB: 05/26/1999
County: Dekalb
Street: 2939 N. Dekald Dr. #107
City: Doraville
State: GA

Zip

30340-

Home

(770) 457-3286

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Minerva Aguilar	10/18/1976	Mexico
Father	Valentin Barrita	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: Y. Garcia