Pancho - GUR-DAM-92

Code: GUR-DAM-92
Mercy ID: V-00240-11
Encounter Date: 03/28/2001
Last: Gutierrez
First: Damali
DOB: 11/13/1992
County: Fulton
Street: 5320 Roswell Rd. Apt F4
City: Atlanta
State: GA

Zip

30342-

Home

(404) 943-9940

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	ana maria petatan	05/23/1976	Mexico
Father	heliodoro gutierrez	03/04/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: jonhson ferry
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