MEN-ASH-00

Code
MEN-ASH-00
Mercy ID
V-00506-13
Encounter Date
10/02/2002
Last
Mendez
First
Ashli
DOB
04/02/2000
County
Dekalb
Street
1800 Memorial Dr. Apt. J3
City
Atlanta
State
GA
Zip
00000-0000
Home
(404) 373-5197
Family Status
Attached youth
COB
Mexico
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Mendez 08/02/1979 Mexico
Father N/A N/A Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
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
Y. Garcia
Data Entry
K. Aleman