RIV-FER-98

Code
RIV-FER-98
Mercy ID
V-02635-21
Encounter Date
05/05/2009
Last
Rivas
First
Fernando
DOB
01/12/1998
County
Dekalb
Street
3852 Mcelroy J-3
City
Doraville
State
GA
Zip
30340-
Home
(678) 530-0419
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Home Owner
YES

Parents Information

Name DOB COB
Mother Adulfa Flores 12/31/1968 Mexico
Father N/A N/A Mexico
Step Parent Miguel Arroyo 04/23/1970 Mexico
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother w/Stepfather
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