HER-GIE-82
- Code
- HER-GIE-82
- Mercy ID
- V-02055-01
- Encounter Date
- 10/07/2005
- Last
- Hernandez
- First
- Giesi
- DOB
- 10/06/1982
- County
- Fulton
- Street
- 66 Northwood
- City
- Sandy springs
- State
- GA
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
- No
- Limitado Educativo
- No
- Limitado Impresos
- No
- Limitado Caminar Latino
- No
NOTES
Media
NO DOY PERMISO
- Intake
- G. Landeros
- Data Entry
- R. Gonzalez