Pancho - GUE-MAR-91

Code: GUE-MAR-91
Mercy ID: V-01895-11
Encounter Date: 04/06/2005
Last: Guevara
First: Maricruz
DOB: 05/03/1991
County: Dekalb
Street: 772 Jolly Ave S Apt J3
City: Clarkston
State: GA

Zip

30021-

Home

(770) 912-0702

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Marta Medina	05/01/1971	Mexico
Father	Francisco Guevara	07/05/1962	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: N/A
Grade: 7th.
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