Pancho - LOP-XIO-93

Code: LOP-XIO-93
Mercy ID: V-02040-13
Encounter Date: 09/28/2005
Last: Lopez
First: Xiomara
DOB: 09/16/1993
County: Gwinnett
Street: 3410 Palisdale Lake Dr
City: Duluth
State: GA

Zip

30096-

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

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: Duluth Middle
Grade: 6th.
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: F. Gomez
Data Entry: R. Gonzalez