Pancho - GAL-ASH-03

Code: GAL-ASH-03
Mercy ID: V-01686-11
Encounter Date: 09/08/2004
Last: Gallegos
First: Ashley
DOB: 12/06/2003
County: Fulton
Street: 5401 Old National Hwy Apt 1416
City: College park
State: GA

Zip

30349-

Home

(404) 763-9669

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Araceli de la Cruz Gonzal	11/17/1978	Mexico
Father	Gustavo Gallegos	12/09/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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