Pancho - GON-EDW-95

Code: GON-EDW-95
Mercy ID: V-00976-21
Encounter Date: 07/17/2002
Last: Gonzalez vargas
First: Edwin
DOB: 05/03/1995
County: Fulton
Street: 338 Walk Creek
City: Roswell
State: GA

Zip

30076-

Home

(678) 357-7936

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Erika Vargas	03/08/1974	Mexico
Father	Samuel Gonzalez	04/18/1969	Mexico
Step Parent	Marco A. Cardozo	10/03/1975	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: N/A
Grade: 2nd.
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