MOT-BRI-08

Code
MOT-BRI-08
Mercy ID
V-03034-11
Encounter Date
03/25/2009
Last
Mota
First
Briana
DOB
06/16/2008
County
Gwinnett
Street
1134 Seasson Parkway
City
Norcross
State
GA
Zip
30093-
Cell
(678) 353-5179
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Yomaira Guzman 10/14/1983 Dominican Rep
Father Biany Mota 08/04/1983 Dominican Rep
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