HER-NOR-75

Code
HER-NOR-75
Mercy ID
V-01455-01
Encounter Date
01/05/2004
Last
Herrera
First
Norma
DOB
04/25/1975
County
Fulton
Street
5675 Roswell Rd.
City
Sandy spring
State
GA
Zip
30342-
Home
(678) 705-1763
Cell
(404) 484-0826
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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. Manzo
Data Entry
K. Aleman