Pancho - CRU-JAV-88

Code: CRU-JAV-88
Mercy ID: V-01942-24
Encounter Date: 08/17/2005
Last: Cruz
First: Javier
DOB: 09/21/1988
County: Gwinnett
Street: 4262 Apt A Pleasant Lake Village
City: Duluth
State: GA

Zip

30096-

Home

(770) 497-9564

Cell

(678) 698-2487

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Marta Cruz	08/24/1964	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: Volunteer
Data Entry: K. Aleman