Pancho - HER-LID-37

Code: HER-LID-37
Mercy ID: V-03048-01
Encounter Date: 04/13/2009
Last: Hernandez
First: Lidia
DOB: 07/24/1937
County: Gwinnett
Street: 2146 Sugar Valley Lane
City: Lawrenceville
State: GA

Zip

30043-

Cell

(404) 713-4391

Family Status

Single adult

COB

Guatemala

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: G. Landeros
Data Entry: J. Manzo