CAL-JOR-05

Code
CAL-JOR-05
Mercy ID
V-02268-21
Encounter Date
10/08/2006
Last
Calderon
First
Jorge
DOB
04/06/2005
County
Dekalb
Street
3510 Buford Hwy G-4
City
Atlanta
State
GA
Zip
30329-
Home
(678) 663-5543
Cell
(678) 368-7055
Family Status
Child/Youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Marta Ortiz 07/28/1977 Mexico
Father Ismael Cortez 08/12/1976 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
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
G. Landeros
Data Entry
J. Manzo