Code
HEZ-MAR-73
Mercy ID
V-01738-01
Encounter Date
10/27/2004
Last
Hernandez
First
Maribel
DOB
08/17/1973
County
Gwinnett
Street
P. O. Box 97
City
Decatur
State
GA
Zip
30031-
Cell
(404) 425-4290
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
College Degree
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