Pancho - BEL-EMA-03

Code: BEL-EMA-03
Mercy ID: V-03323-22
Encounter Date: 05/12/2010
Last: Bello
First: Emanuel
DOB: 06/29/2003
County: Dekalb
Street: 3506 Buford Hwy Apt. B-3
City: Atlanta
State: GA

Zip

30329-

Cell

(770) 875-8257

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Clara Palacios	08/12/1977	Mexico
Father	Hilario Bello	08/27/1975	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: monclair elem
Grade: 2nd.
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: C. Martinez
Data Entry: J. Manzo