Pancho - IXC-LID-77

Code: IXC-LID-77
Mercy ID: V-02261-01
Encounter Date: 05/31/2006
Last: Ixchop
First: Lidia
DOB: 10/10/1977
County: Gwinnett
Street: Gwinnett Square Apt #1202
City: Duluth
State: GA

Zip

00000-

Home

(770) 256-4277

Cell

(678) 933-9084

Family Status

Single adult

COB

Guatemala

Gender

Female

Housing

Doubling Up

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