PAJ-MIA-04

Code
PAJ-MIA-04
Mercy ID
V-02649-11
Encounter Date
11/21/2007
Last
Pajares
First
Mia
DOB
09/12/2004
County
Cobb
Street
4925 Sjallow Ridge Rd.
City
Kennesaw
State
GA
Zip
30144-
Cell
(404) 496-4698
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 Rocio Ramirez 02/12/1970 Perú
Father Jorge Pajares 03/22/1969 Perú
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
Transfiguration Catholic
Grade
Daycare
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