Pancho - LOP-FAT-00

Code: LOP-FAT-00
Mercy ID: V-02138-11
Encounter Date: 01/18/2006
Last: Lopez
First: Fatima
DOB: 04/16/2000
County: Gwinnett
Street: 5133 Westover Circle
City: Lilburn
State: GA

Zip

30047-

Cell

(770) 378-8290

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Post Grad Degree

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Lorena Valencia	04/06/1979	Mexico
Father	Jose Refugio Lopez	05/05/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Hopkins Elem.
Grade: Kinder
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: Volunteer
Data Entry: R. Gonzalez