Pancho - ROD-NAI-09

Code: ROD-NAI-09
Mercy ID: V-03160-21
Encounter Date: 01/06/2010
Last: Rodriguez
First: Naim
DOB: 10/27/2009
County: Cobb
Street: 48 Oxford Road
City: Marietta
State: GA

Zip

30008-

Cell

(678) 334-3663

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Noemi Rodriguez	08/15/1976	Mexico
Father	Moises Antonio Rodrigues	05/17/1974	Nicaragua
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
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