BER-STE-02

Code
BER-STE-02
Mercy ID
V-01617-11
Encounter Date
07/07/2004
Last
Bernal
First
Stephanie
DOB
06/15/2002
County
Fulton
Street
000 Not given
City
Not given
State
GA
Zip
N/A
Home
(000) 000-0000
Family Status
Attached youth
COB
Mexico
Gender
Female Child
Housing
Other
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Arizbeth Marin 04/25/1985 Mexico
Father Rosendo Bernal 03/01/1978 Mexico
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