Pancho - CUM-GLO-71

Code: CUM-GLO-71
Mercy ID: V-02230-01
Encounter Date: 04/23/2006
Last: Cumatz
First: Gloria
DOB: 03/02/1971
County: Gwinnett
Street: 1202 Gwinnett Square Cr
City: Duluth
State: GA

Zip

30096-

Home

(770) 248-4396

Cell

(770) 882-9849

Family Status

Two parent family w/children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

Preschool

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: R. Gonzalez