Pancho - VAR-KEV-00

Code: VAR-KEV-00
Mercy ID: V-00653-21
Encounter Date: 09/05/2001
Last: Vargas diaz
First: Kevin
DOB: 12/03/2000
County: Gwinnett
Street: 460 Sunny Side Dr.
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 923-6724

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Reymunda Diaz	11/20/1979	Mexico
Father	Zenon Vargas	04/12/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: K. Aleman