MAZ-CHE-07

Code
MAZ-CHE-07
Mercy ID
V-01118-61
Encounter Date
12/17/2008
Last
Mazariego
First
Christian
DOB
01/13/2007
County
Cobb
Street
490 Windy Hill Road Apt. 435
City
Smyrna
State
GA
Zip
30082-
Cell
(678) 608-9589
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Sandra Mazariego-Deceased N/A El Salvador
Father N/A N/A Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
***Zaida Ramirez Legal Guardian***
Lives With
Brenda Claribel Mora
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
C. Martinez
Data Entry
J. Manzo