Pancho - HER-GEO-98

Code: HER-GEO-98
Mercy ID: V-01536-21
Encounter Date: 03/24/2004
Last: Hernandez
First: Geovanni
DOB: 11/03/1998
County: Gwinnett
Street: 5545 Bowers Rd
City: Stone mountain
State: GA

Zip

30087-

Home

(404) 512-7315

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Laura Camacho	02/13/1972	Mexico
Father	Jose Luis Hernandez	06/13/1968	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Peach Crest
Grade: Pre-K
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: C. Collier
Data Entry: K. Aleman