Pancho - IZA-GER-95

Code: IZA-GER-95
Mercy ID: V-01443-22
Encounter Date: 07/14/2004
Last: Izaguirre
First: Gerardo
DOB: 05/07/1995
County: Gwinnett
Street: 5614 Executive Way
City: Norcross
State: GA

Zip

30371-

Home

(770) 449-1882

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	Azucena Dueñez B.	04/29/1974	Mexico
Father	Jose Luis Izaguirre B.	03/29/1956	Mexico
Step Parent	Ronan Lucero	07/14/1969	Guatemala

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Norcross Elementary
Grade: 4th.
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