SEG-EDS-06

Code
SEG-EDS-06
Mercy ID
V-02615-22
Encounter Date
11/14/2007
Last
Segura
First
Edson
DOB
08/10/2006
County
Gwinnett
Street
6660 Buckingham Court
City
Norcross
State
GA
Zip
30093-
Cell
(678) 993-7752
Family Status
Attached youth
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Zhenia Jaime 09/30/1973 Mexico
Father Jose Alfredo Segura 03/16/1972 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
YES
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
YES
Limitado Impresos
No
Limitado Caminar Latino
YES
Intake
Volunteer
Data Entry
J. Manzo