Pancho - LUG-KIA-99

Code: LUG-KIA-99
Mercy ID: V-00974-12
Encounter Date: 08/20/2003
Last: Lugo
First: Kiara
DOB: 02/05/1999
County: Gwinnett
Street: 228 Griffin ST.
City: Lawrenceville
State: GA

Zip

30045-

Home

(770) 682-3130

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Consuelo Dominguez	12/17/1973	Dominican Rep
Father	Alexander Lugo	N/A	EEUU
Step Parent	N/A	N/A	N/A

Driver: No
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: Y. Garcia
Data Entry: K. Aleman