Pancho - FLO-GLA-68

Code: FLO-GLA-68
Mercy ID: V-01401-01
Encounter Date: 11/06/2003
Last: Flores
First: Gladys
DOB: 01/11/1968
County: Dekalb
Street: 211 Winter Park Dr.
City: Atlanta
State: GA

Zip

30360-

Home

(404) 312-2608

Family Status

Single parent w/children

COB

Ecuador

Gender

Female

Housing

Not Homeless

Education Level

Some College

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: J. Perez
Data Entry: K. Aleman