FER-JUA-62

Code
FER-JUA-62
Mercy ID
V-00726-01
Encounter Date
10/26/2001
Last
Fernandez
First
Juanita
DOB
05/16/1962
County
Clayton
Street
1035 Scott Rd.
City
Riverdale
State
GA
Zip
30294-
Home
(770) 997-1662
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Some College
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
YES
Relative
No
Stranger
No
NOTES
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. Perez
Data Entry
K. Aleman