Pancho - LOZ-HIL-74

Code: LOZ-HIL-74
Mercy ID: V-02829-01
Encounter Date: 06/02/2008
Last: Lozano
First: Hilari
DOB: 01/14/1974
County: Fulton
Street: 2208 Verbena St
City: Atlanta
State: GA

Zip

30314-

Cell

(678) 608-5898

Family Status

Adult couple-no 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: No
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