HER-MEL-65

Code
HER-MEL-65
Mercy ID
V-00196-01
Encounter Date
05/09/2000
Last
Hernandez
First
Melinda
DOB
07/11/1965
County
Gwinnett
Street
4039 Steelwater Dr.
City
Duluth
State
GA
Zip
30096-
Home
(678) 924-9923
Family Status
Single parent w/children
COB
Nicaragua
Gender
Female
Housing
Not Homeless
Education Level
Some College
Home Owner
YES

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. Manzo
Data Entry
Y. Garcia