GUZ-BRA-04

Code
GUZ-BRA-04
Mercy ID
V-03034-22
Encounter Date
03/25/2009
Last
Guzman
First
Brandon
DOB
09/02/2004
County
Gwinnett
Street
1134 Seasson Parkway
City
Norcross
State
GA
Zip
30093-
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 Yomaira Guzman 10/14/1983 Dominican Rep
Father Enrique del Pilar 04/26/1982 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