Pancho - LOP-MAR-72

Code: LOP-MAR-72
Mercy ID: V-00645-01
Encounter Date: 07/19/2001
Last: Lopez
First: Maribel
DOB: 01/11/1972
County: Other
Street: 5 Broadway
City: Hawthorne
State: NY

Zip

30083-

Home

(914) 747-4785

Family Status

Single parent w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

Grade school

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: YES
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: K. Aleman