Pancho - LOP-VER-81

Code: LOP-VER-81
Mercy ID: V-02711-01
Encounter Date: 02/14/2008
Last: Lopez
First: Veronica
DOB: 02/01/1981
County: Gwinnett
Street: 2192 Newbury Rd. Lot 25-B
City: Norcross
State: GA

Zip

30071-

Cell

(678) 906-0234

Family Status

Two parent family w/children

COB

Mexico

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: 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