PET-BEN-98

Code
PET-BEN-98
Mercy ID
V-00593-21
Encounter Date
08/08/2001
Last
Petatan
First
Benjamin
DOB
07/21/1998
County
Fulton
Street
5320 Roswell Rd. Apt. F-3
City
Atlanta
State
GA
Zip
30342-
Home
(404) 256-4173
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 Maria Marcial 01/24/1981 Mexico
Father Benjamin Lopez N/A Mexico
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
K. Aleman
Data Entry
K. Aleman