Pancho - FLO-CRI-00

Code: FLO-CRI-00
Mercy ID: V-00329-25
Encounter Date: 11/01/2000
Last: Flores
First: Cristobal
DOB: 09/26/2000
County: Dekalb
Street: 3028 Chamblee Tucker Rd. C-6
City: Chamblee
State: GA

Zip

30341-

Home

(770) 458-6439

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Leticia Zuñiga	09/30/1968	Mexico
Father	Benito Flores	03/21/1968	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
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: J. Manzo
Data Entry: K. Aleman