Pancho - JUA-LUC-61

Code: JUA-LUC-61
Mercy ID: V-02163-01
Encounter Date: 02/07/2006
Last: Juares
First: Lucila
DOB: 09/17/1961
County: Fulton
Street: 3102 Dogwood Dr
City: Happeville
State: GA

Zip

30354-

Home

(770) 446-2748

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

Education Level

Grade 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: No
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: G. Landeros
Data Entry: R. Gonzalez