Pancho - FLO-JOS-75

Code: FLO-JOS-75
Mercy ID: V-00788-41
Encounter Date: 03/08/2002
Last: Flores
First: Jose
DOB: 12/06/1975
County: Gwinnett
Street: 304 Austell
City: Norcross
State: GA

Zip

30094-

Home

(678) 523-0686

Family Status

Adult coupie-no children

COB

Venezuela

Gender

Male

Housing

Doubling Up

Education Level

Post Grad Degree

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: F. Perez
Data Entry: K. Aleman