Pancho - LAG-MAR-68

Code: LAG-MAR-68
Mercy ID: V-01252-01
Encounter Date: 06/20/2003
Last: Lagos
First: Maria
DOB: 01/08/1968
County: Gwinnett
Street: 3267 Buford Hwy 720 Suite
City: Atlanta
State: GA

Zip

30339-

Home

(678) 557-2532

Family Status

Single adult

COB

Honduras

Gender

Female

Housing

Doubling Up

Education Level

some high school

Home Owner

YES

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