Pancho - COR-TEZ-02

Code: COR-TEZ-02
Mercy ID: V-03467-22
Encounter Date: 12/08/2010
Last: Cortez
First: Emanuel
DOB: 10/09/2002
County: Fulton
Street: 3360 Penny Lane # H
City: East point
State: GA

Zip

30344-

Cell

(817) 350-9064

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Susana Acoltzi	02/22/1976	Mexico
Father	Ricardo Cortez	12/19/1969	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Monte Olived Elementary School
Grade: 2nd.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: G. Landeros
Data Entry: J. Manzo