Pancho - GON-HEL-03

Code: GON-HEL-03
Mercy ID: V-02821-11
Encounter Date: 06/25/2008
Last: Gonzalez
First: Helen
DOB: 07/07/2003
County: Cobb
Street: 3289 Lancer Cr.
City: Power spring
State: GA

Zip

30127-

Cell

(770) 349-9945

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria elena Nuñez	12/29/1981	Mexico
Father	Armando Gonzalez	07/13/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Campton Elem.
Grade: Kinder
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: F. Gomez
Data Entry: J. Manzo