MAT-JOS-98

Code
MAT-JOS-98
Mercy ID
V-01392-22
Encounter Date
10/29/2003
Last
Mata
First
Jose daniel
DOB
09/12/1998
County
Dekalb
Street
1843 A Skyland Terrace
City
Atlanta
State
GA
Zip
30319-
Home
(404) 638-6899
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Villanueva 05/06/1971 Mexico
Father Jose Mata 09/18/1977 Mexico
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
K. Aleman
Data Entry
K. Aleman