CEN-EMI-04

Code
CEN-EMI-04
Mercy ID
V-03341-11
Encounter Date
06/16/2010
Last
Cenobio
First
Emily
DOB
02/10/2004
County
Dekalb
Street
4612 Peachtree Place Apt. E
City
Doraville
State
GA
Zip
30360-
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Preschool
Home Owner
YES

Parents Information

Name DOB COB
Mother Liliana Custodio 05/11/1986 Mexico
Father Norberto Cenobio 06/06/1981 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
High Tower Elem
Grade
Kinder
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