HER-DEL-06

Code
HER-DEL-06
Mercy ID
V-02782-12
Encounter Date
05/19/2010
Last
Hernandez
First
Delilah
DOB
07/19/2006
County
Gwinnett
Street
1153 Balboa Court
City
Norcross
State
GA
Zip
30093-
Cell
(404) 551-6768
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Home Owner
No

Parents Information

Name DOB COB
Mother Nuvia Villeda 09/01/1977 Honduras
Father Hilario Hernandez 10/28/1963 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
YES
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
C. Martinez
Data Entry
J. Parker