Pancho - PER-ALI-98

Code: PER-ALI-98
Mercy ID: V-00322-11
Encounter Date: 10/25/2000
Last: Perez gomez
First: Ali
DOB: 03/13/1998
County: Gwinnett
Street: 2120 Golden Valley Dr
City: Lawrenceville
State: GA

Zip

30043-

Home

(770) 962-6201

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Orquidea Gomez	07/18/1969	Mexico
Father	Jorge Perez	06/06/1974	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Jackson Elementary
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: Y. Garcia