Pancho - LOP-MAR-68

Code: LOP-MAR-68
Mercy ID: V-00184-01
Encounter Date: 04/18/2000
Last: Lopez
First: Maria
DOB: 06/28/1968
County: Cobb
Street: 949 Shilon Ridge Run NW
City: Kennesaw
State: GA

Zip

30144-

Home

(770) 429-3881

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Not Homeless

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: J. Perez
Data Entry: D. Gomez