Pancho - LOP-ANT-94

Code: LOP-ANT-94
Mercy ID: V-00813-21
Encounter Date: 01/30/2002
Last: Lopez
First: Anthony
DOB: 09/16/1994
County: Gwinnett
Street: 2010 Harrison Ridge
City: Lawrenceville
State: GA

Zip

30044-

Home

(770) 338-9630

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Gertrudy López	08/25/1971	Dominican Rep
Father	Anthony López	12/18/1973	Dominican Rep
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Cedaghill Elementary
Grade: 1st.
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: Y. Garcia
Data Entry: K. Aleman