CER-BRA-02

Code
CER-BRA-02
Mercy ID
V-03072-21
Encounter Date
05/13/2009
Last
Cervantes
First
Brayan
DOB
10/20/2002
County
Clayton
Street
6355 ValleyDale
City
Riverdale
State
GA
Zip
30274-
Cell
(678) 368-6568
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Preschool
Home Owner
YES

Parents Information

Name DOB COB
Mother Yesenia Barajas 02/07/1980 Mexico
Father Roberto Cervantes 09/22/1973 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
Name of School
Riverdale Elem
Grade
Kinder
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