Pancho - LOT-MAR-74

Code: LOT-MAR-74
Mercy ID: V-01563-01
Encounter Date: 04/07/2004
Last: Lotero
First: Margarita
DOB: 06/03/1974
County: Gwinnett
Street: 4498 Bufford Hwy Lt. 300
City: Norcross
State: GA

Zip

30071-

Home

(678) 754-7820

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: No
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