Pancho - GOM-FRA-00

Code: GOM-FRA-00
Mercy ID: V-00180-11
Encounter Date: 07/11/2001
Last: Gomez
First: Francis
DOB: 01/06/2000
County: Gwinnett
Street: 3402 Fox St.
City: Duluth
State: GA

Zip

30096-

Home

(678) 417-0106

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Roxana Gomez	03/05/1962	Perú
Father	Frank Gomez	12/18/1965	EEUU
Step Parent	N/A	N/A	N/A

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

Intake: K. Aleman
Data Entry: K. Aleman