Pancho - SWE-BRA-06

Code: SWE-BRA-06
Mercy ID: V-02699-21
Encounter Date: 08/18/2008
Last: Swenson
First: Braedon
DOB: 09/02/2006
County: Fulton
Street: 999 Shelter
City: Atlanta
State: GA

Zip

99999-

Cell

(856) 220-6157

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Shelter

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Patricia Franco	06/23/1982	Mexico
Father	Gary Swenson	09/05/1975	USA
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo