Pancho - BUR-DAV-89

Code: BUR-DAV-89
Mercy ID: V-01227-21
Encounter Date: 05/14/2003
Last: Burciaga
First: David
DOB: 09/26/1989
County: Gwinnett
Street: 6204 Josephine Rd.
City: Doraville
State: GA

Zip

30340-

Home

(770) 441-9273

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Maria Burciaga	05/06/1966	Mexico
Father	Salvador Burciaga	05/23/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: SummerHOur Middle
Grade: 6th.
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