Pancho - CON-CAR-95

Code: CON-CAR-95
Mercy ID: V-02787-21
Encounter Date: 05/21/2008
Last: Contreras
First: Carlos
DOB: 05/02/1995
County: Gwinnett
Street: 5543 Bottom Gwinnett
City: Norcross
State: GA

Zip

30093-

Cell

(404) 468-2420

Family Status

Child/Youth

COB

El Salvador

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Rosa Contreras	11/16/1973	El Salvador
Father	Carlos Tejado	N/A	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Liliburn Middle
Grade: 6th.
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