Pancho - HER-MAR-62

Code: HER-MAR-62
Mercy ID: V-01682-01
Encounter Date: 08/16/2004
Last: Hernandez
First: Marina
DOB: 01/22/1962
County: Dekalb
Street: not given
City: Not given
State: GA

Zip

00000-0000

Home

(678) 467-3204

Family Status

Single adult

COB

Mexico

Gender

Female

Housing

Transitional

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: YES
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: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Manzo
Data Entry: K. Aleman