Pancho - GOM-FRA-99

Code: GOM-FRA-99
Mercy ID: V-00558-21
Encounter Date: 06/27/2001
Last: Gomez
First: Frank
DOB: 01/17/1999
County: Dekalb
Street: 2749 Shallowford Rd. #D
City: Chamblee
State: GA

Zip

30341-

Home

(770) 986-4250

Family Status

Attached youth

COB

Guatemala

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Hilda Garcia	09/20/1975	Guatemala
Father	Cesar Gomez	N/A	Guatemala
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: K. Aleman
Data Entry: K. Aleman