Pancho - FON-MAR-91

Code: FON-MAR-91
Mercy ID: V-00693-21
Encounter Date: 11/28/2001
Last: Fontaine
First: Marco
DOB: 02/03/1991
County: Gwinnett
Street: 7740 Poppy Dr.
City: Winston
State: GA

Zip

30187-

Home

(770) 942-8285

Cell

(678) 525-0942

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Ivonne Fontaine	02/27/1973	Mexico
Father	Marco Fontaine	09/18/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Winston Elementary
Grade: 5th.
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: Y. Garcia
Data Entry: K. Aleman