Pancho - GUT-DAN-01

Code: GUT-DAN-01
Mercy ID: V-02498-21
Encounter Date: 05/23/2007
Last: Gutierrez
First: Daniel
DOB: 05/08/2001
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

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Araceli Trejo	01/27/1984	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: Dresden
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: Volunteer
Data Entry: J. Manzo