Pancho - MAR-BRA-94

Code: MAR-BRA-94
Mercy ID: V-00349-21
Encounter Date: 01/15/2003
Last: Marin
First: Braulio
DOB: 06/21/1994
County: Gwinnett
Street: 2560 Wildflower Ln.
City: Lawrenceville
State: GA

Zip

30044-

Home

(678) 376-9146

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Adriana Correa	08/31/1964	Mexico
Father	Octavio Marin	09/04/1962	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Benny Field 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: Y. Garcia
Data Entry: K. Aleman