HER-ASH-07

Code
HER-ASH-07
Mercy ID
V-03220-12
Encounter Date
12/02/2009
Last
Hernandez
First
Ashley
DOB
04/11/2007
County
Gwinnett
Street
3240 Sunrise Lane Apt. C
City
Norcross
State
GA
Zip
30093-
Cell
(404) 259-4649
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Ana Platero 04/09/1979 Mexico
Father Raul Hernandez 07/16/1978 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
mom
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
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
YES
Intake
C. Martinez
Data Entry
J. Manzo