Pancho - GUE-MIT-91

Code: GUE-MIT-91
Mercy ID: V-00790-14
Encounter Date: 03/30/2005
Last: Guevara
First: Mitzi
DOB: 05/11/1991
County: Gwinnett
Street: 302 Chase Lane
City: Norcross
State: GA

Zip

30093-

Home

(770) 416-8571

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

some high school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Mitzi Medrano	01/04/1970	El Salvador
Father	Jose Guevara	10/08/1969	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Lilburn Middle
Grade: 8th.
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. Perilla
Data Entry: K. Aleman