Pancho - HER-BEA-73

Code: HER-BEA-73
Mercy ID: V-01466-01
Encounter Date: 01/13/2004
Last: Hernandez
First: Beatriz
DOB: 03/10/1973
County: Gwinnett
Street: 6259 South North Cross
City: Tucker
State: GA

Zip

30084-

Home

(678) 406-9813

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
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman