FER-LIL-72

Code
FER-LIL-72
Mercy ID
V-01418-01
Encounter Date
11/21/2003
Last
Fernandez
First
Lili
DOB
12/10/1972
County
Gwinnett
Street
919 Merrymclave
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 755-8613
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate
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