Pancho - GAR-JOS-95

Code: GAR-JOS-95
Mercy ID: V-00802-21
Encounter Date: 01/09/2002
Last: Garcia
First: Jose
DOB: 07/11/1995
County: Gwinnett
Street: 5628 Harvinwood Rd.
City: Norcross
State: GA

Zip

30093-

Home

(770) 923-2170

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	Alma Garcia	11/18/1971	Mexico
Father	Jose Garcia	09/24/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: DK
Grade: 1st.
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