Pancho - MAR-ERI-96

Code: MAR-ERI-96
Mercy ID: V-00195-23
Encounter Date: 05/03/2000
Last: Martinez
First: Eric
DOB: 09/17/1996
County: Gwinnett
Street: 5141 Stone Mountain Hwy L- 212
City: Stone mountain
State: GA

Zip

30087-

Cell

(770) 378-1070

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	Luz Elena Martinez	09/12/1966	Mexico
Father	Juan Carlos Martinez	03/04/1963	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Trickeum Middle
Grade: 7th.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: K. Aleman
Data Entry: K. Aleman