Pancho - PRU-LOU-78

Code: PRU-LOU-78
Mercy ID: V-01995-01
Encounter Date: 08/17/2005
Last: Prudente
First: Lourdes
DOB: 03/16/1978
County: Dekalb
Street: 3700 Bufford Hwy #15
City: Atlanta
State: GA

Zip

30329-

Home

(404) 321-6126

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

High school graduate

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