CAL-MAN-05

Code
CAL-MAN-05
Mercy ID
V-02250-21
Encounter Date
05/17/2006
Last
Calderon
First
Manuel
DOB
11/15/2005
County
Cobb
Street
490 Windy Hill Apt #2223
City
Smyrna
State
GA
Zip
30082-
Home
(678) 524-0799
Family Status
Attached youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Jessica Calderon 01/11/1988 Guatemala
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
R. Gonzalez
Data Entry
R. Gonzalez