PUA-LUI-04

Code
PUA-LUI-04
Mercy ID
V-02251-21
Encounter Date
06/28/2006
Last
Puac
First
Luis alexis
DOB
01/19/2004
County
Dekalb
Street
102 Winter Creek
City
Doraville
State
GA
Zip
30360-
Home
(678) 615-3816
Family Status
Attached youth
COB
Mexico
Gender
Male Child
Housing
Not Homeless
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Maritza Laynez 08/18/1978 Guatemala
Father Luis Puac 06/21/1970 Guatemala
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
R. Gonzalez
Data Entry
R. Gonzalez