BAS-JOS-02

Code
BAS-JOS-02
Mercy ID
V-01640-41
Encounter Date
06/30/2004
Last
Bastida
First
Jose angel
DOB
08/11/2002
County
Fulton
Street
6937 Roswell Rd. Apt 4
City
Atlanta
State
GA
Zip
30328-
Home
(770) 393-8521
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Erika Bastida N/A Mexico
Father N/A N/A Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Sobrino de Imelda Leticia Bastida (Ella siempre lo cuida)
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
K. Aleman
Data Entry
K. Aleman