ZAM-AND-04

Code
ZAM-AND-04
Mercy ID
V-01823-23
Encounter Date
02/02/2005
Last
Zamarripa
First
Andy
DOB
08/31/2004
County
Dekalb
Street
3160 Buford Hwy Apt H3
City
Atlanta
State
GA
Zip
30329-
Home
(678) 755-5312
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Tania Carrasco 03/28/1980 Mexico
Father Fernando Zamarripa 06/01/1979 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
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