HER-EMI-02

Code
HER-EMI-02
Mercy ID
V-00182-12
Encounter Date
02/19/2003
Last
Herrera
First
Emily
DOB
07/23/2002
County
Fulton
Street
145 Northwood Dr. Apt. B-7
City
Atlanta
State
GA
Zip
30342-
Cell
(404) 438-4071
Family Status
Attached youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Grade school
Home Owner
YES

Parents Information

Name DOB COB
Mother Diega Petatan 11/14/1964 Mexico
Father Victor Herrera 11/12/1970 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
Name of School
LakeForest elem
Grade
1st.
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
Y. Garcia
Data Entry
K. Aleman