Pancho - FLO-MER-75

Code: FLO-MER-75
Mercy ID: V-00749-01
Encounter Date: 11/08/2001
Last: Flores
First: Maribel
DOB: 12/31/1975
County: Cobb
Street: 1201 Eastside #118
City: Marietta
State: GA

Zip

30060-

Home

(770) 771-3378

Family Status

Two parent family w/children

COB

Mexico

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: 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: G. Landeros
Data Entry: K. Aleman