Pancho - GUT-GAB-99

Code: GUT-GAB-99
Mercy ID: V-02332-21
Encounter Date: 09/27/2006
Last: Gutierrez
First: Gabriel
DOB: 10/05/1999
County: Cobb
Street: 1613 Bridge Mill Dr. Apt. K
City: Marietta
State: GA

Zip

30067-

Home

(678) 789-1476

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	Maria Gaytan	11/18/1978	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Brumby Elem
Grade: 2nd.
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: J. Manzo