Pancho - DEL-FER-02

Code: DEL-FER-02
Mercy ID: V-02701-21
Encounter Date: 02/05/2008
Last: Delgado
First: Fernando
DOB: 10/10/2002
County: Gwinnett
Street: 1374 Country Downs Drive
City: Norcross
State: GA

Zip

30093-

Cell

(678) 789-2906

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alicia Cruz	12/28/1974	Mexico
Father	Azael Delgado	05/16/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Little Adorable Shelter
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: G. Landeros
Data Entry: J. Manzo