Pancho - MAR-WIL-00

Code: MAR-WIL-00
Mercy ID: V-02270-21
Encounter Date: 06/14/2006
Last: Martinez
First: William jr
DOB: 09/28/2000
County: Gwinnett
Street: 659 South Wind Dr
City: Lilburn
State: GA

Zip

30047-

Home

(678) 665-5168

Cell

(770) 256-8200

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Beisy Carranza	02/26/1976	Honduras
Father	William Martinez	08/25/1973	Honduras
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Lilburn Elem
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: R. Gonzalez
Data Entry: R. Gonzalez