MAY-JES-08

Code
MAY-JES-08
Mercy ID
V-01424-22
Encounter Date
01/27/2010
Last
Maya
First
Jesus
DOB
05/16/2008
County
Dekalb
Street
3353-B Peachtree Corner Circle
City
Norcross
State
GA
Zip
30092-
Cell
(770) 895-3016
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Adela Maya 06/17/1973 Mexico
Father N/A N/A Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
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
Volunteer
Data Entry
J. Manzo