BAR-MIL-06

Code
BAR-MIL-06
Mercy ID
V-03185-11
Encounter Date
10/28/2009
Last
Barrera
First
Milagros
DOB
08/27/2006
County
Clayton
Street
7735 Tara Blvd. L-E 33
City
Jonesboro
State
GA
Zip
30236-
Home
(770) 472-7565
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 Piedad merino 11/24/1969 Mexico
Father mario Barrera Navarro 02/02/1972 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
Medical Alert
NOTES
Alergia a Lactos
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