Pancho - CRU-GER-05

Code: CRU-GER-05
Mercy ID: V-01839-21
Encounter Date: 08/31/2005
Last: Cruz
First: Gerson
DOB: 07/09/2005
County: Gwinnett
Street: 3213 Quail Lake
City: Norcross
State: GA

Zip

30093-

Home

(404) 944-0516

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Reyna Velasco	11/16/1984	Mexico
Father	Vidal Cruz	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: K. Aleman
Data Entry: K. Aleman