ROS-EZE-01

Code
ROS-EZE-01
Mercy ID
V-01856-21
Encounter Date
03/23/2005
Last
Rostro
First
Ezequiel
DOB
06/13/2001
County
Dekalb
Street
3373 Aztec Rd. Apt 15
City
Doraville
State
GA
Zip
30340-
Home
(404) 246-5898
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Orquida Rostro 10/11/1983 Mexico
Father Ezequiel Rostro 11/14/1970 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