Pancho - GAL-CAR-03

Code: GAL-CAR-03
Mercy ID: V-02720-21
Encounter Date: 02/27/2008
Last: Galindo
First: Carlos
DOB: 09/20/2003
County: Fulton
Street: 636 Jackson Park Lane
City: Suwanee
State: GA

Zip

30024-

Cell

(404) 771-9809

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Shelter

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Aracely Galindo	07/09/1982	Honduras
Father	Carlos Ayala	06/01/1953	Mexico
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: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo