URB-CES-03

Code
URB-CES-03
Mercy ID
V-00777-22
Encounter Date
09/29/2004
Last
Urbina
First
Cesar
DOB
09/27/2003
County
Gwinnett
Street
4162 Creek Hollow Way
City
Duluth
State
GA
Zip
30096-
Home
(770) 840-8641
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Arcedalia Velazquez 03/24/1980 Mexico
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
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
Y. Garcia
Data Entry
K. Aleman