Pancho - GAY-ALE-03

Code: GAY-ALE-03
Mercy ID: V-02026-21
Encounter Date: 03/08/2006
Last: Gaytan
First: Alex
DOB: 10/23/2003
County: Dekalb
Street: 3559 Pleasant Brook Village
City: Atlanta
State: GA

Zip

30340-

Home

(678) 534-1297

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Veronica Cid	04/01/1976	Mexico
Father	Jorge Gayton	11/28/1977	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Stripling School
Grade: Kinder
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: R. Gonzalez