OSE-ASH-08

Code
OSE-ASH-08
Mercy ID
V-03522-13
Encounter Date
02/16/2011
Last
Oseguera
First
Ashley
DOB
06/21/2008
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
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Ivis Argentina Sierra 06/08/1972 Honduras
Father N/A N/A 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

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