RUB-KAT-00

Code
RUB-KAT-00
Mercy ID
V-01749-11
Encounter Date
11/03/2004
Last
Rubio
First
Katherine
DOB
09/03/2000
County
Gwinnett
Street
818 Stillwater
City
Lawrenceville
State
GA
Zip
30044-
Home
(000) 000-0000
Family Status
Attached youth
COB
Dominican Rep
Gender
Female Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Ruth Gorrell 05/13/1973 Dominican Rep
Father Jose Ceferino Rubio N/A Dominican Rep
Step Parent Anthony Gorrell 09/16/1964 USA
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
J. Perilla
Data Entry
K. Aleman