HER-MAR-73

Code
HER-MAR-73
Mercy ID
V-01696-01
Encounter Date
09/01/2004
Last
Hernandez
First
Maria elena
DOB
06/10/1973
County
Cobb
Street
1636 Donna Street
City
Mableton
State
GA
Zip
30126-
Home
(770) 597-0443
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Some College
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