Pancho - CRU-BRI-92

Code: CRU-BRI-92
Mercy ID: V-00013-21
Encounter Date: 01/05/2000
Last: Cruz
First: Brian
DOB: 04/29/1992
County: Dekalb
Street: 3297 hood ave
City: Chamblee
State: GA

Zip

30341-

Home

(770) 936-0781

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	cruz sonia	08/07/1978	USA
Father	hernandez nelson	03/07/1970	Guatemala
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: ?
Grade: 2nd.
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: J. Manzo
Data Entry: D. Gomez