BUR-BRI-91

Code
BUR-BRI-91
Mercy ID
V-01227-22
Encounter Date
05/14/2003
Last
Burciaga
First
Brian
DOB
11/28/1991
County
Gwinnett
Street
6204 Josephine Rd.
City
Doraville
State
GA
Zip
30340-
Home
(770) 441-9273
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Grade school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Burciaga 05/06/1966 Mexico
Father Salvador Burciaga 05/23/1971 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
Stripling Elementary
Grade
4th.
Who Can't Pickup the Child

Media

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