LOP-JUA-98

Code
LOP-JUA-98
Mercy ID
V-00729-21
Encounter Date
05/24/2002
Last
Lopez
First
Juan carlos
DOB
04/27/1998
County
Fulton
Street
5801 Kingsport Apt.138
City
Atlanta
State
GA
Zip
30342-
Home
(404) 459-0956
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Rocio Garcia 01/19/1977 Mexico
Father Juan Carlos Lopez 05/11/1978 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
This intake was done with information from the mothers' file because I couldn't get the mother on the phone and Juan Carlos has been coming the group so I needed the intake.
Lives With
Parents
Name of School
Do not Know
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