Pancho - FIG-EDG-06

Code: FIG-EDG-06
Mercy ID: V-02768-21
Encounter Date: 05/07/2008
Last: Figueroa
First: Edgar
DOB: 02/02/2006
County: Gwinnett
Street: 2004 Marsh Creek Drive
City: Lawrenceville
State: GA

Zip

30043-

Cell

(678) 538-8496

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Guadalupe Gomez	07/20/1983	Mexico
Father	Edgar Figueroa	01/16/1984	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: C. Martinez
Data Entry: J. Manzo