CHA-JES-74

Code
CHA-JES-74
Mercy ID
V-03044-02
Encounter Date
04/14/2009
Last
Chavez
First
Jesus
DOB
02/01/1974
County
Dekalb
Street
3185 Cedar Brook Dr.
City
Decatur
State
GA
Zip
30033-
Cell
(404) 992-4729
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school
Home Owner
No

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
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
J. Manzo
Data Entry
J. Manzo