FAV-GRI-73

Code
FAV-GRI-73
Mercy ID
V-01835-01
Encounter Date
02/17/2005
Last
Hernandez
First
Griselda
DOB
09/19/1973
County
Gwinnett
Street
400 Stone Hill Dr.
City
Stone mountain
State
GA
Zip
00000-0000
Home
(770) 498-1434
Cell
(678) 789-2280
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
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
No
NOTES
On 4/13/05 Griselda requested that her last name be changed to Hernandez. Formerly known as Favela
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
G. Landeros
Data Entry
K. Aleman