Pancho - GOM-DAP-92

Code: GOM-DAP-92
Mercy ID: V-00246-11
Encounter Date: 07/05/2000
Last: Gomez
First: Daphne
DOB: 01/25/1992
County: Gwinnett
Street: 3972 Withrow Dr.
City: Doraville
State: GA

Zip

30340-

Home

(770) 209-9622

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Carolina Martinez	11/04/1965	Mexico
Father	Elliiott Gomez	03/28/1964	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Oackliff 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: C. Martinez
Data Entry: Y. Garcia