Pancho - LOP-ADI-91

Code: LOP-ADI-91
Mercy ID: V-00089-11
Encounter Date: 11/30/2005
Last: Lopez
First: Adileni
DOB: 07/17/1991
County: Gwinnett
Street: 5665 Bladwin
City: Norcross
State: GA

Zip

30071-

Cell

(678) 732-7363

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Other

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria Lopez	11/15/1971	Mexico
Father	Mariano Arellano	02/15/1966	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: 7th.
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: Volunteer
Data Entry: R. Gonzalez