Pancho - LOP-KEV-99

Code: LOP-KEV-99
Mercy ID: V-01034-21
Encounter Date: 05/05/2004
Last: Lopez
First: Kevin antonio
DOB: 02/08/1999
County: Gwinnett
Street: 355 Rockbridge Rd.
City: Lilburn
State: GA

Zip

30047-

Home

(770) 925-9562

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Lourdes Lopez	08/29/1969	Mexico
Father	Marco Antonio Noriega	01/28/1972	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Little Adorable
Grade: Pre-K
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