HER-MAR-67

Code
HER-MAR-67
Mercy ID
V-00632-01
Encounter Date
05/28/2002
Last
Hernandez
First
Marta
DOB
05/21/1967
County
Cobb
Street
120 Johston Pkway
City
Kennessaw
State
GA
Zip
30152-
Home
(770) 422-5227
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
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
YES
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
K. Aleman