Pancho - VAR-LAU-79

Code: VAR-LAU-79
Mercy ID: V-01037-01
Encounter Date: 11/13/2002
Last: Vargas
First: Laura
DOB: 06/27/1979
County: Gwinnett
Street: 475 Lexington Dr.
City: Lawrenceville
State: GA

Zip

30045-

Home

(678) 407-2628

Family Status

Two parent family w/children

COB

Mexico

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: 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: J. Perez
Data Entry: K. Aleman