Pancho - CRU-DAV-94

Code: CRU-DAV-94
Mercy ID: V-01942-25
Encounter Date: 06/29/2005
Last: Cruz
First: David
DOB: 10/16/1994
County: Gwinnett
Street: 4262 A Pleasant Lake
City: Duluth
State: GA

Zip

30096-

Home

(770) 497-9564

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	martha cruz	08/24/1965	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Chelsey Elementary
Grade: 4th.
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