Pancho - DIA-FRA-97

Code: DIA-FRA-97
Mercy ID: V-00794-21
Encounter Date: 01/09/2002
Last: Diaz
First: Franklin
DOB: 07/15/1997
County: Gwinnett
Street: 1355 Graves Rd. Apt. X3
City: Norcross
State: GA

Zip

30093-

Home

(770) 934-1026

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria del Rosario	02/24/1969	Dominican Rep
Father	Franklin Diaz	12/28/1974	Dominican Rep
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Kids- r- Kids
Grade: Pre-K
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