LOP-LIL-84

Code
LOP-LIL-84
Mercy ID
V-01651-01
Encounter Date
07/14/2004
Last
Lopez
First
Liliana
DOB
03/08/1984
County
Dekalb
Street
International Women's House
City
Other
State
GA
Zip
00000-0000
Home
(000) 000-0000
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
Child, not in 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
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
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