BER-CHR-99

Code
BER-CHR-99
Mercy ID
V-00868-21
Encounter Date
03/20/2002
Last
Bernal
First
Christian
DOB
02/18/1999
County
Fulton
Street
1460 North Cliff Valley Way
City
Atlanta
State
GA
Zip
30319-
Home
(000) 000-0000
Cell
(000) 000-0000
Family Status
Attached youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Bernal 10/31/1975 Mexico
Father Raul Canchola N/A EEUU
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
Y. Garcia
Data Entry
K. Aleman