HER-GUI-54

Code
HER-GUI-54
Mercy ID
V-03021-01
Encounter Date
03/10/2009
Last
Herrera
First
Guillermina
DOB
08/06/1954
County
Gwinnett
Street
966 Livel Creek Road
City
Sugarhill
State
GA
Zip
30518-
Cell
(678) 508-5902
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education
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