MAR-WIL-05

Code
MAR-WIL-05
Mercy ID
V-03263-21
Encounter Date
02/24/2010
Last
Marin
First
William
DOB
09/27/2005
County
Dekalb
Street
3193 Buford Hwy Apt. A
City
Atlanta
State
GA
Zip
30329-
Cell
(404) 399-1269
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Maria Elena Rendon 02/15/1973 Mexico
Father Guillermo Marin 10/20/1971 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

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