HER-JAY-01

Code
HER-JAY-01
Mercy ID
V-00727-11
Encounter Date
03/06/2002
Last
Hernandez
First
Jaydy
DOB
08/07/2001
County
Fulton
Street
315 Karen Dr.
City
Alpharetta
State
GA
Zip
30004-
Home
(770) 777-0469
Family Status
Attached youth
COB
Mexico
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Ana Hernandez 03/20/1969 Mexico
Father Oscar Hernandez 04/21/1970 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
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
Y. Garcia
Data Entry
K. Aleman