Pancho - LOP-SON-79

Code: LOP-SON-79
Mercy ID: V-01075-01
Encounter Date: 01/07/2003
Last: Lopez
First: Sonia
DOB: 07/13/1979
County: Gwinnett
Street: 580 Telfair Ct.
City: Suwannee
State: GA

Zip

30024-

Home

(678) 407-9436

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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