GAR-GIS-05

Code
GAR-GIS-05
Mercy ID
V-03156-13
Encounter Date
10/14/2009
Last
Garcia
First
Giselle
DOB
03/04/2005
County
Douglass
Street
4486 Cherokee Dr. L-56
City
Douglasville
State
GA
Zip
30134-
Cell
(404) 483-8935
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
No

Parents Information

Name DOB COB
Mother Blanca Garcia 04/27/1973 Mexico
Father Armando Monroy 08/18/1968 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
C. Martinez
Data Entry
J. Manzo