LPZ-LET-67

Code
LPZ-LET-67
Mercy ID
V-03243-01
Encounter Date
01/28/2010
Last
Lopez
First
Leticia
DOB
04/28/1967
County
Clayton
Street
624 Redfox Trail
City
Jonesboro
State
GA
Zip
30238-
Cell
(678) 683-5237
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
YES
Relative
No
Stranger
No
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
YES
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perez
Data Entry
J. Manzo