GUA-ALE-05

Code
GUA-ALE-05
Mercy ID
W-00004-21
Encounter Date
09/23/2009
Last
Guajardo
First
Alec
DOB
06/29/2005
County
Hall
Street
1213 Crest Park Point
City
Gainsville
State
GA
Zip
30504-
Cell
(770) 630-4071
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Grade school
Home Owner
YES

Parents Information

Name DOB COB
Mother Damaryz Gomez 02/21/1981 Mexico
Father Noey Guajardo 10/09/1980 USA
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
Centenial Art Academy
Grade
Kinder
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
C. Martinez
Data Entry
J. Manzo