VIA-JUA-02

Code
VIA-JUA-02
Mercy ID
V-03432-22
Encounter Date
09/29/2010
Last
Viazcan
First
Juan carlos
DOB
06/24/2002
County
Dekalb
Street
6800 north chain boulevard
City
Doraville
State
GA
Zip
30360-
Cell
(404) 566-1417
Family Status
Single parent w/children
COB
Mexico
Gender
Male Child
Housing
Single Family
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother Edith Yaneli Viazcan 02/25/1983 Mexico
Father Enrique Garcia Sanchez 09/10/1979 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
Medical Alert
NOTES
La escuela le mando medicamento para la hiperactividad, pero no los tomo
Lives With
Mother
Name of School
Hightower Elem.
Grade
2nd.
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