DYM-BRI-04

Code
DYM-BRI-04
Mercy ID
V-02895-11
Encounter Date
10/01/2004
Last
Dymant
First
Brianna
DOB
05/05/2004
County
Forsyth
Street
7125 Jonesway Road
City
Cumming
State
GA
Zip
30041-
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Natalia Dymant 11/09/1978 Uruguay
Father Luis Dymant 06/20/1969 USA
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
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Manzo