MEJ-WYL-06

Code
MEJ-WYL-06
Mercy ID
V-00464-22
Encounter Date
03/28/2008
Last
Mejia
First
Wylly
DOB
09/21/2006
County
Fulton
Street
4825 Northbridge Dr.
City
Alpharetta
State
GA
Zip
30022-
Home
(770) 619-3272
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Liliana Mejia 03/04/1976 Mexico
Father Wilfredo Mejia 12/09/1969 Honduras
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
N/A
Grade
N/A
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
G. Landeros
Data Entry
J. Manzo