Pancho - JAR-LOU-78

Code: JAR-LOU-78
Mercy ID: V-02870-01
Encounter Date: 08/11/2008
Last: Jarquin
First: Lourdes
DOB: 07/16/1978
County: Gwinnett
Street: 4415 Mcord Libsey Road
City: Snellville
State: GA

Zip

30039-

Cell

(678) 758-6734

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

some high 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: J. Perez
Data Entry: J. Manzo