MEJ-LAR-03

Code
MEJ-LAR-03
Mercy ID
V-01651-11
Encounter Date
07/14/2004
Last
Mejia
First
Larissa
DOB
11/13/2003
County
Dekalb
Street
International Women's House
City
Other
State
GA
Zip
00000-0000
Home
(000) 000-0000
Family Status
Attached youth
COB
Mexico
Gender
Female Child
Housing
Shelter
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Liliana Lopez 03/08/1984 Mexico
Father Cesar Mejia 07/10/1983 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
Y. Garcia
Data Entry
K. Aleman