LOP-ANA-79

Code
LOP-ANA-79
Mercy ID
V-02483-01
Encounter Date
05/02/2007
Last
Lopez
First
Ana patricia
DOB
02/06/1979
County
Spalding
Street
244 Kent Lane
City
Douglassville
State
GA
Zip
30134-
Cell
(404) 702-5319
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma
Home Owner
YES

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
YES
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
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