Pancho - GOM-EMM-97

Code: GOM-EMM-97
Mercy ID: V-01336-22
Encounter Date: 10/24/2003
Last: Gomez
First: Emmanuel
DOB: 05/13/1997
County: Dekalb
Street: 2203 Plaster Rd. Apt. D6
City: Atlanta
State: GA

Zip

30345-

Home

(770) 873-1157

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maritza Bustamante	06/22/1971	Mexico
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Dresden Elementary
Grade: 1st.
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: K. Aleman