Pancho - SAN-BRA-04

Code: SAN-BRA-04
Mercy ID: V-02184-23
Encounter Date: 03/08/2006
Last: Santiago
First: Brayan yahir
DOB: 07/22/2004
County: Gwinnett
Street: 6485 Bannor Ln
City: Norcross
State: GA

Zip

30092-

Cell

(678) 886-4058

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Patricia Espino	12/21/1973	Mexico
Father	Jesus Santiago	12/07/1974	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: Volunteer
Data Entry: R. Gonzalez