Pancho - DAJ-LUC-77

Code: DAJ-LUC-77
Mercy ID: V-01676-01
Encounter Date: 08/05/2004
Last: Dajui
First: Lucia
DOB: 03/04/1977
County: Gwinnett
Street: 940 Kirtly Way
City: Lawrenceville
State: GA

Zip

30045-

Home

(770) 256-9762

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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