PER-DAN-04

Code
PER-DAN-04
Mercy ID
V-02906-23
Encounter Date
02/09/2009
Last
Perez
First
Daniel
DOB
09/05/2004
County
Gwinnett
Street
6656 E. Windsor Ln.
City
Norcross
State
GA
Zip
30093-
Cell
(770) 895-9354
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Eloisa Duran 05/12/1978 Mexico
Father Jose Guadalupe Perea 08/17/1971 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
J. Manzo
Data Entry
J. Manzo