Pancho - GUT-EVE-02

Code: GUT-EVE-02
Mercy ID: V-02498-11
Encounter Date: 05/23/2007
Last: Gutierrez
First: Evelyn
DOB: 05/03/2002
County: Dekalb
Street: 2203 Plaster Rd. Apt. N-5
City: Atlanta
State: GA

Zip

30345-

Home

(404) 447-4182

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Araceli Trejo	01/27/1984	Mexico
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Headstart
Grade: Pre-K
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