Pancho - CHA-GUL-93

Code: CHA-GUL-93
Mercy ID: V-00205-21
Encounter Date: 06/07/2000
Last: Chavez
First: Guillermo
DOB: 03/14/1993
County: Fulton
Street: 1505 Chatahochee Ave Lot 60
City: Atlanta
State: GA

Zip

30318-

Home

(404) 350-0525

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Alejandra Chavez	08/22/1971	Mexico
Father	Guillermo Chavez	02/21/1958	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Margaret Mitchell
Grade: 2nd.
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: K. Aleman
Data Entry: D. Gomez