VIL-MAR-01

Code
VIL-MAR-01
Mercy ID
V-02782-11
Encounter Date
05/19/2010
Last
Villeda
First
Marena
DOB
06/15/2001
County
Gwinnett
Street
1153 Balboa Court
City
Norcross
State
GA
Zip
30093-
Cell
(404) 551-6768
Family Status
Child/Youth
COB
Honduras
Gender
Female Child
Housing
Doubling Up
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother Nuvia Villeda 09/01/1977 Honduras
Father Jose luis Jimenez N/A Honduras
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
Medical Alert
NOTES
Epilepcia. En caso de un ataque, que la acomoden de lado.
Lives With
Mother
Name of School
Nezbith Elem
Grade
3rd.
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