AYA-GLA-91

Code
AYA-GLA-91
Mercy ID
V-01036-12
Encounter Date
03/12/2003
Last
Ayala
First
Gladen
DOB
11/16/1991
County
Fulton
Street
5735 Roswell Rd. Apt. 407
City
Atlanta
State
GA
Zip
30342-
Home
(404) 252-5502
Family Status
Attached youth
COB
Mexico
Gender
Female Child
Housing
Not Homeless
Education Level
Other
Home Owner
No

Parents Information

Name DOB COB
Mother Concepcion Ayala 03/25/1962 Mexico
Father Sergio Ayala N/A Guatemala
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
This intake was done from the mother's information without asking her directly; therefore, ther info. Is as accurate as possible but not guaranteed.
Lives With
Parents
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
K. Aleman
Data Entry
K. Aleman