Pancho - MUÑ-BRI-99

Code: MUÑ-BRI-99
Mercy ID: V-00753-22
Encounter Date: 12/05/2001
Last: Muñoz
First: Brian
DOB: 07/13/1999
County: Gwinnett
Street: 772 River Landing Dr.
City: Lawrenceville
State: GA

Zip

30045-

Home

(770) 682-8853

Family Status

Attached youth

COB

Puerto Rico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Belinda Rivera	04/20/1964	Puerto Rico
Father	Cesar Muñoz	03/25/1963	Perú
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: Y. Garcia
Data Entry: K. Aleman