PAL-GIS-09

Code
PAL-GIS-09
Mercy ID
V-03236-11
Encounter Date
02/10/2010
Last
Palestino
First
Giselle
DOB
09/02/2009
County
Dekalb
Street
4181 Woodwind Ct.
City
Doraville
State
GA
Zip
30340-
Cell
(678) 917-8979
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 maritza Merino 06/16/1991 Mexico
Father Julio Cesar Pa;estino 09/27/1989 USA
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

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