Pancho - HER-HIR-97

Code: HER-HIR-97
Mercy ID: V-02706-23
Encounter Date: 12/17/2008
Last: Hernandez
First: Hiram
DOB: 01/26/1997
County: Fulton
Street: 88 Old Holcombridge Way
City: Roswell
State: GA

Zip

30076-

Home

(770) 649-0949

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Victoria Hernandez	07/28/1974	Mexico
Father	Gabino Chona Guerrero	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Hillside elementary
Grade: 5th.
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: C. Martinez
Data Entry: J. Manzo