Pancho - HER-KAR-91

Code: HER-KAR-91
Mercy ID: V-03381-01
Encounter Date: 08/02/2010
Last: Hernandez
First: Karen
DOB: 10/15/1991
County: Gwinnett
Street: 9999 No quiso darla
City: Norcross
State: GA

Zip

30071-

Cell

(678) 431-8144

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

some high school

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: No
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
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