Pancho - MAT-SAL-95

Code: MAT-SAL-95
Mercy ID: V-00400-24
Encounter Date: 01/31/2001
Last: Mata
First: Salvador
DOB: 07/05/1995
County: Dekalb
Street: 478 p.o. box 163
City: Pine lake
State: GA

Zip

30072-

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	melisa mata	11/20/1960	Mexico
Father	arturo mata	06/10/1957	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: rood ridge
Grade: Kinder
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: S. Aviña