Pancho - SAN-MAN-94

Code: SAN-MAN-94
Mercy ID: V-01956-21
Encounter Date: 07/06/2005
Last: Santana
First: Manuel
DOB: 05/04/1994
County: Gwinnett
Street: 1616 Lia Hills Dr.
City: Norcross
State: GA

Zip

30071-

Home

(678) 663-0710

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Rachael Lopez	09/16/1969	Mexico
Father	Carlos De la Paz	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Norcrss Elementary
Grade: 4th.
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: Volunteer
Data Entry: K. Aleman