Pancho - HER-GUA-76

Code: HER-GUA-76
Mercy ID: V-00406-01
Encounter Date: 02/05/2001
Last: Hernandez
First: Guadalupe
DOB: 11/26/1976
County: Not given
Street: 1422 1/2 Wetside Rd
City: Gainsville
State: GA

Zip

30501-

Home

(770) 297-7404

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high school

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: 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: D. Gomez