VAS-LIS-05

Code
VAS-LIS-05
Mercy ID
V-02588-11
Encounter Date
09/12/2007
Last
Vasquez
First
Lisette
DOB
01/27/2005
County
Gwinnett
Street
1180 Avalon Dr
City
Lawrenceville
State
GA
Zip
30044-
Cell
(770) 885-7556
Family Status
Attached youth
COB
USA
Gender
Female Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Adrian Espino 01/27/1982 Mexico
Father William Vasquez 12/24/1979 El Salvador
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
YES
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Manzo