Pancho - AVI-ARE-01

Code: AVI-ARE-01
Mercy ID: V-00903-11
Encounter Date: 05/22/2002
Last: Avila
First: Arely
DOB: 05/15/2001
County: Gwinnett
Street: 3900 Portico Run Dr.
City: Buford
State: GA

Zip

30519-

Home

(678) 482-8375

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Graciela Avila aka Sugey	07/06/1976	Mexico
Father	Angel Avila	06/01/1971	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: Y. Garcia
Data Entry: K. Aleman