FLO-EMM-03

Code
FLO-EMM-03
Mercy ID
V-02111-21
Encounter Date
01/26/2009
Last
Flores
First
Emmanuel
DOB
12/24/2003
County
Gwinnett
Street
4300 Jimmy Carter Blvd. # 720
City
Norcross
State
GA
Zip
30093-
Home
(770) 491-3074
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Preschool
Home Owner
No

Parents Information

Name DOB COB
Mother Margarita Camacho 02/22/1975 Mexico
Father Roberto Flores N/A Mexico
Step Parent Carlos Amaya 10/20/1981 Mexico
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother w/Stepfather
Name of School
sunshine
Grade
Pre-K
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
J. Manzo