LOP-NEI-95
- Code
- LOP-NEI-95
- Mercy ID
- V-02040-12
- Encounter Date
- 09/28/2005
- Last
- Lopez
- First
- Neida
- DOB
- 07/15/1995
- County
- Gwinnett
- Street
- 3410 Palisdale Lake Dr.
- City
- Duluth
- State
- GA
Parents Information
| Name | DOB | COB | |
|---|---|---|---|
| Mother | Claudia Lopez | 03/16/1976 | Mexico |
| Father | N/A | N/A | Mexico |
| Step Parent | N/A | N/A | N/A |
- Driver
- No
- Relative
- No
- Stranger
- No
- Lives With
- Mother
- Name of School
- Chattahoochee Elem.
- Grade
- 5th.
- 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
NOTES
Media
NO DOY PERMISO
- Intake
- F. Gomez
- Data Entry
- R. Gonzalez