CRU-JOR-07

Code
CRU-JOR-07
Mercy ID
V-02956-21
Encounter Date
02/25/2009
Last
Cruz
First
Jorge
DOB
03/31/2007
County
Dekalb
Street
4371 Winters Chapel Rd. Apt. 1305
City
Doraville
State
GA
Zip
30360-
Cell
(404) 549-0520
Family Status
Child/Youth
COB
USA
Gender
Male Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Rubi Medel 12/05/1980 Mexico
Father Jorge Cruz Perez 01/25/1977 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
YES
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Manzo