FER-CON-71

Code
FER-CON-71
Mercy ID
V-00486-01
Encounter Date
05/08/2001
Last
Fernandez
First
Confesora
DOB
06/01/1971
County
Other
Street
000 Some Street
City
Some city
State
GA
Zip
00000-0000
Home
(404) 634-9604
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Other
Education Level
Other
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
NOTES
This clients documents were burned in May2001therefore her information is incomplete.
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
K. Aleman