RIV-NER-76

Code
RIV-NER-76
Mercy ID
V-03450-02
Encounter Date
11/02/2010
Last
Rivera
First
Nery
DOB
07/01/1976
County
Dekalb
Street
2569 New Heaven Dr. Apt. F
City
Atlanta
State
GA
Zip
30345-
Cell
(404) 934-6811
Family Status
Single adult
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
Grade school
Home Owner
No

Parents Information

Name DOB COB
Mother N/A N/A N/A
Father N/A N/A N/A
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
N/A
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
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
J. Manzo