Pancho - LUJ-ADR-74

Code: LUJ-ADR-74
Mercy ID: V-01711-01
Encounter Date: 08/19/1974
Last: Lujan
First: Adriana
DOB: 08/19/1974
County: Gwinnett
Street: 1218 Indian Way
City: Lilburn
State: GA

Zip

30047-

Home

(404) 454-7924

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

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