Pancho - VAZ-NAT-99

Code: VAZ-NAT-99
Mercy ID: V-02884-22
Encounter Date: 09/03/2008
Last: Vazquez
First: Nathan
DOB: 08/26/1999
County: Gwinnett
Street: 4775 Saint Bernard Drive
City: Lilburn
State: GA

Zip

30047-

Home

(770) 559-4622

Cell

(770) 256-3847

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Yolanda Gonzalez	11/25/1965	Mexico
Father	Jaime Vazquez	02/02/1963	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Mountain Park Elem
Grade: 3rd.
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