Pancho - QUI-FRE-97

Code: QUI-FRE-97
Mercy ID: V-01520-21
Encounter Date: 03/10/2004
Last: Quintana
First: Freddy
DOB: 08/06/1997
County: Fulton
Street: 1216 Wood Creek Trl.
City: Roswell
State: GA

Zip

30076-

Home

(770) 912-4040

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Other

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Martha Quintana	N/A	Mexico
Father	Blas Terijos	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Hillside
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: K. Aleman