MED-ALI-98

Code
MED-ALI-98
Mercy ID
V-00900-11
Encounter Date
04/24/2002
Last
Medina
First
Alicia
DOB
08/04/1998
County
Gwinnett
Street
7060 Winter Brook Ct. Apt 64
City
Atlanta
State
GA
Zip
30060-
Home
(000) 000-0000
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 Yuriana Lozano 11/19/1977 Mexico
Father N/A N/A Mexico
Step Parent Rigoberto Ganzeco 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
Y. Garcia
Data Entry
K. Aleman