RUI-JOR-05

Code
RUI-JOR-05
Mercy ID
V-02813-21
Encounter Date
06/11/2008
Last
Ruiz de leon
First
Jorge
DOB
08/19/2005
County
Cobb
Street
4044 George Busbee Pkwy Apt. 8301
City
Dennesaw
State
GA
Zip
30144-
Cell
(404) 375-9282
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Preschool
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Teresa Lopez 11/13/1972 Mexico
Father Jorge Ruiz de leon 08/12/1968 Puerto Rico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
St. Catherine School
Grade
Pre-K
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
F. Gomez
Data Entry
J. Manzo