Pancho - LOP-YAR-93

Code: LOP-YAR-93
Mercy ID: V-00959-12
Encounter Date: 09/22/1999
Last: Lopez
First: Yardley
DOB: 01/25/1993
County: Not given
Street: 215 Pleasandale Crossing
City: Doraville
State: GA

Zip

30340-

Home

(770) 996-7343

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Transitional

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Blanca Botella	09/20/1972	Mexico
Father	Hoger Lopez	10/18/1971	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Pleasandale Elementary
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. Manzo
Data Entry: K. Aleman