Pancho - MEN-LUC-72

Code: MEN-LUC-72
Mercy ID: V-01478-01
Encounter Date: 02/04/2004
Last: Mendoza
First: Luciana
DOB: 11/01/1972
County: Cherokee
Street: 1172 Bretly Park Ln.
City: Woodstock
State: GA

Zip

30189-

Home

(770) 591-2216

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Post Grad Degree

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