Pancho - LOZ-ERI-01

Code: LOZ-ERI-01
Mercy ID: V-02299-21
Encounter Date: 08/23/2006
Last: Lozano
First: Erik
DOB: 02/17/2001
County: Rockdale
Street: 1757 Hunting Creek Dr.
City: Conyers
State: GA

Zip

30013-

Home

(770) 929-3231

Family Status

Attached youth

COB

USA

Gender

Male Child

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Marta Lozano	09/16/1978	Mexico
Father	Jose Rangel	12/10/1976	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Flat Schoal 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: G. Landeros
Data Entry: J. Manzo