Pancho - LOP-GAB-94

Code: LOP-GAB-94
Mercy ID: V-01286-22
Encounter Date: 07/30/2003
Last: Lopez
First: Gabriel
DOB: 03/23/1994
County: Dekalb
Street: 3600 Shallowford Rd. Apt. D7
City: Atlanta
State: GA

Zip

30341-

Home

(770) 458-9116

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Martha Lopez	12/08/1964	Guatemala
Father	Carlos Lopez	01/31/1961	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Cary Reynolds
Grade: 7th.
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