Pancho - MOR-SAR-04

Code: MOR-SAR-04
Mercy ID: V-01953-12
Encounter Date: 07/06/2005
Last: Moreno
First: Sarabi
DOB: 11/24/2004
County: Gwinnett
Street: 6259 S. Norcross Apt L5
City: Tucker
State: GA

Zip

30084-

Cell

(404) 484-2776

Family Status

Attached youth

COB

El Salvador

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Daris Argueta	02/01/1982	El Salvador
Father	Roberto Moreno	11/25/1976	El Salvador
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: Y. Garcia
Data Entry: K. Aleman