FON-HER-59

Code
FON-HER-59
Mercy ID
V-01407-01
Encounter Date
11/04/2003
Last
Fonseca
First
Herminia
DOB
06/22/1959
County
Hall
Street
P.O. Box 2962
City
Gainsville
State
GA
Zip
30501-
Home
(678) 521-7688
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Transitional
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
YES
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. Manzo
Data Entry
K. Aleman