Pancho - ZAC-AND-00

Code: ZAC-AND-00
Mercy ID: V-02230-21
Encounter Date: 04/26/2006
Last: Zacarias
First: Andy yvan
DOB: 11/05/2000
County: Gwinnett
Street: 1202 Gwinnett Square Cl
City: Duluth
State: GA

Zip

30096-

Home

(770) 248-4396

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Gloria M Cumatz	03/02/1971	Guatemala
Father	Juan Zacarias	N/A	Guatemala
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: R. Gonzalez
Data Entry: R. Gonzalez