Pancho - GON-LES-03

Code: GON-LES-03
Mercy ID: V-01647-12
Encounter Date: 06/30/2004
Last: Gonzalez
First: Leslie
DOB: 07/17/2003
County: Gwinnett
Street: 3108 Park Colony
City: Norcross
State: GA

Zip

30093-

Home

(678) 508-8415

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Rosario Rodriguez	05/16/1981	Mexico
Father	Aurelio Gonzalez	N/A	Mexico
Step Parent	N/A	09/09/1979	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
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