Pancho - LOZ-FAT-75

Code: LOZ-FAT-75
Mercy ID: V-02299-12
Encounter Date: 08/23/2006
Last: Contreras
First: Fatima
DOB: 05/18/1995
County: Rockdale
Street: 1757 Hunting Creek Dr.
City: Conyers
State: GA

Zip

30013-

Home

(770) 929-3231

Family Status

Attached youth

COB

Mexico

Gender

Female Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Marta Lozano	09/16/1978	Mexico
Father	Jose Rangel	12/12/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Memorial Middle School
Grade: 6th.
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: J. Manzo