Pancho - ARC-GUS-97

Code: ARC-GUS-97
Mercy ID: V-00871-22
Encounter Date: 03/20/2002
Last: Arce
First: Gustavo jr
DOB: 05/25/1997
County: Dekalb
Street: 2903 Alcoa Ct .
City: Chamblee
State: GA

Zip

30341-

Home

(770) 986-2726

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	Reyna Pereyra	04/24/1971	Mexico
Father	Gustavo Arce	01/22/1965	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