SIL-PAM-05

Code
SIL-PAM-05
Mercy ID
V-03169-13
Encounter Date
10/21/2009
Last
Silva
First
Pamela
DOB
08/05/2005
County
Gwinnett
Street
5911 Hunt Club Run # D
City
Norcross
State
GA
Zip
30093-
Cell
(770) 369-0910
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Susana Aparicio 09/30/1976 Mexico
Father Luis E. Silva 10/30/1973 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