Pancho - LOP-MAR-71

Code: LOP-MAR-71
Mercy ID: V-00089-01
Encounter Date: 11/15/2005
Last: Lopez
First: Maria estela
DOB: 11/15/1971
County: Gwinnett
Street: 3208 Lia Hilla Drive
City: Norcross
State: GA

Zip

30071-

Home

(678) 732-7363

Family Status

Single parent 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: YES
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: G. Landeros
Data Entry: R. Gonzalez