CIS-GUS-86

Code
CIS-GUS-86
Mercy ID
V-00212-21
Encounter Date
05/17/2000
Last
Cisneros
First
Gustavo
DOB
06/01/1986
County
Dekalb
Street
Tilly Mill
City
Doraville
State
GA
Zip
30360-
Home
(678) 530-0634
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Doubling Up
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother Maria del Carmen Acocal 06/01/1966 Mexico
Father Bacilio Cisneros 01/14/1966 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Father
Name of School
Peachtree
Grade
8th.
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. Perez
Data Entry
K. Aleman