Pancho - LOP-VIL-76

Code: LOP-VIL-76
Mercy ID: V-01318-01
Encounter Date: 08/12/2003
Last: Lopez
First: Vilma
DOB: 02/26/1976
County: Dekalb
Street: Not Known
City: Any city
State: GA

Zip

00000-0000

Home

(678) 547-0075

Family Status

Two parent family w/children

COB

Guatemala

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: 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