GON-ARE-02

Code
GON-ARE-02
Mercy ID
V-03019-11
Encounter Date
03/18/2009
Last
Gonzalez
First
Arely
DOB
10/04/2002
County
Dekalb
Street
1344 Northcliff Valley Way A-1
City
Atlanta
State
GA
Zip
30319-
Cell
(678) 755-7535
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Grade school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Paz Corpus 04/12/1981 Mexico
Father Manuel Gonzalez 01/06/1978 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
Woolworth Elem
Grade
1st.
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
YES
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
YES
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Manzo