BAR-KEV-02

Code
BAR-KEV-02
Mercy ID
V-01616-21
Encounter Date
07/07/2004
Last
Barraza
First
Kevin j
DOB
02/01/2002
County
Dekalb
Street
P.O. Box 1327
City
Decatur
State
GA
Zip
30031-
Home
(404) 297-5753
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Shelter
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
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