HER-HIL-09

Code
HER-HIL-09
Mercy ID
V-03353-11
Encounter Date
08/18/2010
Last
Hernandez
First
Hillary
DOB
06/24/2009
County
Fulton
Street
2431 Morosco Way Apt. E
City
Atlanta
State
GA
Zip
30324-
Cell
(404) 370-2137
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Doubling Up
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Selene Ignacio 12/23/1979 Mexico
Father Alfredo Hernandez 05/05/1980 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

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