ZIM-YAT-06

Code
ZIM-YAT-06
Mercy ID
V-03382-11
Encounter Date
08/04/2010
Last
Zimbron
First
Yatzari
DOB
12/17/2006
County
Dekalb
Street
7062 Rogers Lake Rd. Apt. 6
City
Lithonia
State
GA
Zip
30058-
Cell
(404) 951-4152
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 Lizett Luna Hernandez 03/01/1981 Mexico
Father Gerardo Zimbron Hernandez 11/02/1978 Mexico
Step Parent zz 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