JER-GIL-71

Code
JER-GIL-71
Mercy ID
V-00631-02
Encounter Date
05/21/2002
Last
Carillo
First
Gilberto jeronimo
DOB
07/10/1971
County
Cherokee
Street
181 Lee St.
City
Canton
State
GA
Zip
30114-
Home
(678) 493-3974
Family Status
Two parent family w/children
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
some high school
Home Owner
YES

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
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
R. Miranda
Data Entry
K. Aleman