Pancho - MEJ-LOR-64

Code: MEJ-LOR-64
Mercy ID: V-01187-01
Encounter Date: 04/09/2003
Last: Mejia
First: Lorena
DOB: 10/18/1964
County: Fulton
Street: 1606 Well Swood St.
City: Atlanta
State: GA

Zip

30315-

Home

(404) 627-5246

Family Status

Single parent w/children

COB

El Salvador

Gender

Female

Housing

Not Homeless

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: YES
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. Manzo
Data Entry: K. Aleman