Pancho - FLO-PAM-01

Code: FLO-PAM-01
Mercy ID: V-02819-12
Encounter Date: 06/18/2008
Last: Flores
First: Pamela
DOB: 11/23/2001
County: Clayton
Street: 6059 Ledgewood Drive
City: Forest park
State: GA

Zip

30297-

Cell

(404) 957-3005

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Luisa Flores	01/26/1972	El Salvador
Father	Mario Flores	12/19/1972	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Saint John
Grade: 1st.
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. Gomez
Data Entry: J. Manzo