ROD-JOS-89

Code
ROD-JOS-89
Mercy ID
V-03433-02
Encounter Date
09/28/2010
Last
Rodriguez
First
Jose
DOB
01/02/1989
County
Dekalb
Street
3630 Shallowford Rd. C-6
City
Doraville
State
GA
Zip
30340-
Cell
(404) 573-9782
Family Status
Single adult
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
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. Manzo
Data Entry
J. Manzo