DEL-JOH-04

Code
DEL-JOH-04
Mercy ID
V-02701-22
Encounter Date
02/05/2008
Last
Delgado
First
John
DOB
08/30/2004
County
Gwinnett
Street
1374 Country downs Drive
City
Norcross
State
GA
Zip
30093-
Cell
(678) 789-2906
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Alicia Cruz 12/28/1974 Mexico
Father Azael Delgado 05/16/1975 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
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo