PAD-KAT-04

Code
PAD-KAT-04
Mercy ID
V-02414-11
Encounter Date
03/14/2007
Last
Padilla
First
Kati jasiela
DOB
11/08/2004
County
Dekalb
Street
2555 Pilgrim Way # B
City
Atlanta
State
GA
Zip
30345-
Home
(678) 927-5073
Family Status
Attached youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Lilian Padilla 03/12/1983 Honduras
Father Manuel de Jesus Mejia N/A Honduras
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
C. Martinez
Data Entry
J. Manzo