Pancho - GUE-HEN-73

Code: GUE-HEN-73
Mercy ID: V-02293-02
Encounter Date: 08/08/2006
Last: Guevara
First: Henry
DOB: 08/22/1973
County: Gwinnett
Street: 735 Marthas Drive
City: Lawrenceville
State: GA

Zip

30045-

Home

(770) 963-8122

Cell

(404) 697-4739

Family Status

Two parent family w/children

COB

El Salvador

Gender

Male

Housing

Not Homeless

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: N/A
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: J. Manzo
Data Entry: J. Manzo