Pancho - LOP-ANG-53

Code: LOP-ANG-53
Mercy ID: V-01539-01
Encounter Date: 03/22/2004
Last: Lopez
First: Angela
DOB: 11/07/1953
County: Dekalb
Street: 2312 Lawrenceville Hwy
City: Decatur
State: GA

Zip

30033-

Home

(404) 248-9187

Family Status

Adult coupie-no children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Grade 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: YES
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