HER-KAR-73

Code
HER-KAR-73
Mercy ID
V-00058-01
Encounter Date
01/27/2000
Last
Hernandez
First
Carlota
DOB
07/17/1973
County
Dekalb
Street
4096 Phil Niekro Parkway
City
Norcross
State
GA
Zip
30093-
Home
(678) 437-0614
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high 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
Y. Garcia