RIV-ALE-06

Code
RIV-ALE-06
Mercy ID
V-03010-21
Encounter Date
02/18/2009
Last
Rivas
First
Alexis
DOB
06/03/2006
County
Fulton
Street
2748 3erd. Ave. SW
City
Atlanta
State
GA
Zip
30315-
Cell
(678) 927-4402
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 Maribel Rivas 08/21/1988 Mexico
Father N/A N/A 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
C. Martinez
Data Entry
J. Manzo