CONSILIUL LOCAL GALATI

Centrul de Locuinte si Sprijin pentru Tineret

Str. Zimbrului nr. 5 Tel./Fax 406058

ANCHETA SOCIALA
Data efectuarii anchetei:
1. Date de identificare a beneficiarului:
Nume si Prenume:_Poiana
Alexandru_____________________________________
CNP__18008282170158________________________________________
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Data si locul nasterii 28.08.1980__________________________________
Stare civila necasatorit_________________________________________
Religie:__ortodox____________________________________________
Profesie/calificare:__sudor___________________________________
Ultima ocupatie:__muncitor necalificat
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Adresa/telefon:__Str. Zimbrului nr. 5 ______________________________________
2. Centrul de plasament de unde provine:__Centrul de Primire
Minori___________________________
3. Date despre parinti :
______mama Poiana Aurora
tata - necunocut
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4. Starea de sanatate:__- deficienta mintala asociata cu tulburari de
comportament_________________________________________________
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5. Observatii cu privire la perioada petrecuta in centru:

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Data:

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