Pancho - PAL-LOR-77

Code: PAL-LOR-77
Mercy ID: V-01973-01
Encounter Date: 07/25/2005
Last: Palma
First: Lorena
DOB: 08/08/1977
County: Fulton
Street: East Point Ct. Ave #4
City: Atlanta
State: GA

Zip

30344-

Home

(404) 768-8594

Family Status

Adult coupie-no 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: G. Landeros
Data Entry: K. Aleman