Pancho - SUA-AND-04

Code: SUA-AND-04
Mercy ID: V-02110-22
Encounter Date: 01/04/2006
Last: Suarez
First: Andres
DOB: 03/19/2004
County: Dekalb
Street: 3207 Henderson Mill Rd. Apt. P-7
City: Atlanta
State: GA

Zip

30341-

Cell

(678) 973-8439

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Ana Maria Perez	03/11/1973	Mexico
Father	David Suarez	04/03/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Henderson Mill Elem
Grade: Kinder
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: R. Gonzalez