Pancho - VAL-LOR-79

Code: VAL-LOR-79
Mercy ID: V-02138-01
Encounter Date: 01/13/2006
Last: Valencia
First: Lorena
DOB: 04/06/1979
County: Gwinnett
Street: 5133 West Tover Cr
City: Lilburn
State: GA

Zip

30047-

Cell

(770) 378-8290

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

some high 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: YES
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: J. Perez
Data Entry: R. Gonzalez