MEJ-ERI-04

Code
MEJ-ERI-04
Mercy ID
V-02918-21
Encounter Date
04/01/2009
Last
Mejia
First
Erick
DOB
06/28/2004
County
Dekalb
Street
3636 Buford Hwy Apt. 6
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 396-2179
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Karina Morales 01/16/1985 Guatemala
Father Wilfredo Mejia 05/26/1977 Honduras
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
C. Martinez
Data Entry
J. Manzo