QUI-ROS-06

Code
QUI-ROS-06
Mercy ID
V-03037-11
Encounter Date
05/04/2009
Last
Quiroz
First
Rosa
DOB
01/18/2006
County
Dekalb
Street
3460 Buford Hwy Apt. F-1
City
Atlanta
State
GA
Zip
30324-
Cell
(404) 552-8936
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Mireya Aguilar 07/03/1977 Mexico
Father joaquin Quiroz 05/21/1980 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
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
G. Landeros
Data Entry
J. Manzo