Pancho - GUT-JOS-99

Code: GUT-JOS-99
Mercy ID: V-00600-21
Encounter Date: 07/25/2001
Last: Gutierrez
First: Jose luis
DOB: 07/19/1999
County: Fulton
Street: 2421 Morosgo Way Apt. A
City: Atlanta
State: GA

Zip

30324-

Home

(404) 495-0113

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Cecilia Gonzalez	04/14/1970	Mexico
Father	Jose Luis Gutierrez	09/18/1967	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: K. Aleman
Data Entry: K. Aleman