RUI-ERN-03

Code
RUI-ERN-03
Mercy ID
V-02993-23
Encounter Date
01/28/2009
Last
Ruiz
First
Ernesto
DOB
03/21/2003
County
Cobb
Street
1973 St.
City
Austell
State
GA
Zip
30106-
Home
(770) 941-1919
Cell
(770) 633-6705
Family Status
Two parent family w/children
COB
USA
Gender
Male Child
Housing
Single Family
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother Maria Ruiz 07/08/1967 Mexico
Father Roberto Ruiz 09/17/1964 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
Sanders Elem.
Grade
Kinder
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