HER-ROS-82

Code
HER-ROS-82
Mercy ID
V-02757-01
Encounter Date
04/11/2008
Last
Hernandez
First
Rosa maria
DOB
01/30/1982
County
Gwinnett
Street
1720 Rockbridge
City
Norcross
State
GA
Zip
30093-
Cell
(678) 768-0548
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
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
J. Manzo