Pancho - CAS-LUC-74

Code: CAS-LUC-74
Mercy ID: V-02555-01
Encounter Date: 07/26/2007
Last: Martinez
First: Lucelly
DOB: 01/15/1974
County: Fulton
Street: 152 Oak St. #-1
City: Roswell
State: GA

Zip

30045-

Cell

(678) 949-8500

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Transitional

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: YES
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: J. Manzo