Pancho - GRA-NIC-02

Code: GRA-NIC-02
Mercy ID: V-01776-21
Encounter Date: 12/08/2004
Last: Granda
First: Nicolas
DOB: 11/25/2002
County: Gwinnett
Street: 2128 The Falls Parkway
City: Duluth
State: GA

Zip

30096-

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Patricia Velasco	10/13/1967	Perú
Father	Julio Granda	12/12/1964	Perú
Step Parent	N/A	N/A	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