Pancho - DIA-LOR-74

Code: DIA-LOR-74
Mercy ID: V-00079-01
Encounter Date: 02/21/2000
Last: Diaz
First: Lorena
DOB: 12/04/1974
County: Gwinnett
Street: 1575 holcomb bridge rd
City: Norcross
State: GA

Zip

30092-

Home

(678) 291-9876

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

High school graduate

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. Manzo
Data Entry: S. Aviña