Pancho - FLO-SAR-75

Code: FLO-SAR-75
Mercy ID: V-02954-01
Encounter Date: 12/02/2008
Last: Flores
First: Sara
DOB: 10/02/1975
County: Gwinnett
Street: 1985 Holly Circle
City: Lawrenceville
State: GA

Zip

30044-

Cell

(404) 235-2968

Family Status

Single parent w/children

COB

El Salvador

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: 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: G. Landeros
Data Entry: J. Manzo