ROD-SAE-09

Code
ROD-SAE-09
Mercy ID
V-03237-22
Encounter Date
03/24/2010
Last
Rodriguez
First
Sael
DOB
06/15/2009
County
Cobb
Street
1794 James Dr. Apt. A-2
City
Marietta
State
GA
Zip
30060-
Cell
(770) 709-1658
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Nuri leticia Ramos 12/09/1974 Mexico
Father Sael Rodriguez 01/02/1980 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
YES
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
Volunteer
Data Entry
J. Manzo