RIV-ANA-08

Code
RIV-ANA-08
Mercy ID
V-02403-11
Encounter Date
01/27/2010
Last
Rivera
First
Analy
DOB
11/13/2008
County
Clayton
Street
5086 Old Dixie Hwy # 1221
City
Forest park
State
GA
Zip
30296-
Cell
(404) 573-0483
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Erica Chavez 08/14/1988 Mexico
Father Martin Rivera 08/08/1976 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
YES
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
Volunteer
Data Entry
J. Manzo