Pancho - GAR-EMM-00

Code: GAR-EMM-00
Mercy ID: V-01640-21
Encounter Date: 06/30/2004
Last: Garcia
First: Emmanuel
DOB: 01/05/2000
County: Fulton
Street: 6937 Roswell Rd. Apt H
City: Atlanta
State: GA

Zip

30328-

Home

(770) 393-8521

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Imelda Leticia Bastida	05/13/1975	Mexico
Father	Manuel Garcia	05/30/1979	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: N/A
Grade: N/A
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