LOP-SHE-73

Code
LOP-SHE-73
Mercy ID
V-00116-01
Encounter Date
02/02/2000
Last
Lopez
First
Sheny
DOB
01/03/1973
County
Gwinnett
Street
2200 Willow Trail Pkwy B-19
City
Norcross
State
GA
Zip
30093-
Cell
(678) 349-8840
Family Status
Two parent family w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
Grade school
Home Owner
YES

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
YES
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
D. Gomez