ZAM-EFR-07

Code
ZAM-EFR-07
Mercy ID
V-03041-23
Encounter Date
04/15/2009
Last
Zamora
First
Efrain
DOB
03/06/2007
County
Fulton
Street
221 Woodcreek Ct.
City
Roswell
State
GA
Zip
30076-
Cell
(404) 704-2660
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Winnie Bedolla 09/18/1979 Mexico
Father David Zamora 09/27/1979 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
YES
Intake
C. Martinez
Data Entry
J. Manzo