OSE-SCA-03

Code
OSE-SCA-03
Mercy ID
V-03522-12
Encounter Date
02/16/2011
Last
Oseguera
First
Scarlet
DOB
11/22/2003
County
Cobb
Street
1327 Laura Lane
City
Austell
State
GA
Zip
30168-
Cell
(678) 598-2513
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Grade school
Home Owner
YES

Parents Information

Name DOB COB
Mother Ivis Argentina Sierra E. 06/08/1972 Honduras
Father Mario Osegura 02/10/1979 Honduras
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
Medical Alert
NOTES
Marisco, Lexsema
Lives With
Mother
Name of School
Riverside Elem.
Grade
1st.
Who Can't Pickup the Child

Media

DOY PERMISO
Authoritation Parent
YES
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
Volunteer
Data Entry
J. Manzo