Pancho - DEL-BRI-99

Code: DEL-BRI-99
Mercy ID: V-00796-21
Encounter Date: 02/20/2002
Last: Del angel
First: Brian
DOB: 10/02/1999
County: Gwinnett
Street: 40 Kenessaw St.
City: Sugar hill
State: GA

Zip

30518-

Home

(678) 546-7532

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	Rosaura Rico Rodriguez	N/A	Mexico
Father	Sergio del Angel	N/A	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: Y. Garcia
Data Entry: K. Aleman