Pancho - LOP-ANA-62

Code: LOP-ANA-62
Mercy ID: V-01439-01
Encounter Date: 12/11/2003
Last: Lopera
First: Ana ofelia
DOB: 05/17/1962
County: Gwinnett
Street: 1494 Watercrest Cer.
City: Lawrenceville
State: GA

Zip

30043-

Home

(678) 760-0855

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Vocational/Technical

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. Perez
Data Entry: K. Aleman