PAT-JOS-01

Code
PAT-JOS-01
Mercy ID
V-02204-21
Encounter Date
04/12/2006
Last
Patiño jr
First
Jose
DOB
07/01/2001
County
Dekalb
Street
3628 Meadowglen Village Ln
City
Atlanta
State
GA
Zip
30340-
Home
(678) 499-8324
Family Status
Attached youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Rosa Perez 08/27/1985 Mexico
Father Jose Patiño 02/17/1979 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
R. Gonzalez
Data Entry
R. Gonzalez