Pancho - GON-ASH-07

Code: GON-ASH-07
Mercy ID: V-02843-11
Encounter Date: 07/09/2008
Last: Gonzalez
First: Ashley
DOB: 11/13/2007
County: Gwinnett
Street: 815 Twin Springs Trl
City: Norcross
State: GA

Zip

30093-

Cell

(813) 900-6804

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	marcela Morales	01/16/1969	Mexico
Father	Gerardo Gonzalez	03/09/1980	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
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: F. Gomez
Data Entry: J. Manzo