Pancho - TRI-EDM-99

Code: TRI-EDM-99
Mercy ID: V-01864-21
Encounter Date: 04/06/2005
Last: Trinidad
First: Edmundo jr
DOB: 12/13/1999
County: Gwinnett
Street: 503 Hampton Crossing
City: Norcross
State: GA

Zip

30093-

Home

(678) 924-0605

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Edith Contreras	04/09/1975	Mexico
Father	Edmundo Trinidad	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Grandparents
Name of School: Sandel School
Grade: Pre-K
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