Pancho - QUI-ANG-96

Code: QUI-ANG-96
Mercy ID: V-01751-21
Encounter Date: 11/17/2004
Last: Quintero
First: Angel
DOB: 10/07/1996
County: Gwinnett
Street: 3852 Singletree Pla.
City: Norcross
State: GA

Zip

30093-

Home

(678) 698-4761

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Rosalia Garcia	05/11/1979	Mexico
Father	Osvaldo Quintero	05/22/1977	Guatemala
Step Parent	Nestor Sandoval	05/13/1976	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Rebecca Minor
Grade: 2nd.
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: K. Aleman
Data Entry: K. Aleman