HER-LET-64

Code
HER-LET-64
Mercy ID
V-00822-01
Encounter Date
01/25/2002
Last
Herrera
First
Leticia
DOB
02/15/1964
County
Gwinnett
Street
3218 Windscape Valley Lane
City
Norcross
State
GA
Zip
30093-
Home
(678) 481-3345
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
College Degree
Home Owner
YES

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