Pancho - LUG-ELI-66

Code: LUG-ELI-66
Mercy ID: V-03208-01
Encounter Date: 11/13/2009
Last: Lugo
First: Elia
DOB: 04/16/1966
County: Fulton
Street: 125 Northwood Dr # 341
City: Sandy springs
State: GA

Zip

30342-

Cell

(404) 496-2705

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Doubling Up

Education Level

Adult, no formal education

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