Pancho - DEL-LAU-72

Code: DEL-LAU-72
Mercy ID: V-03007-01
Encounter Date: 02/13/2009
Last: De la rosa
First: Laura
DOB: 09/06/1972
County: Gwinnett
Street: 1900 Glennclub Dr. # 602
City: Stone mountain
State: GA

Zip

30087-

Cell

(678) 887-2936

Family Status

Single parent w/children

COB

USA

Gender

Female

Housing

Single Family

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