Pancho - VAS-DAI-03

Code: VAS-DAI-03
Mercy ID: V-02588-22
Encounter Date: 09/12/2007
Last: Vasquez
First: David
DOB: 06/16/2003
County: Gwinnett
Street: 1180 Avalon Dr.
City: Lawrenceville
State: GA

Zip

30044-

Cell

(770) 885-7556

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Adriana Espino	01/27/1982	Mexico
Father	William Vasquez	12/24/1979	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: kindercare
Grade: Pre-K
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo