Pancho - FLO-LUZ-65

Code: FLO-LUZ-65
Mercy ID: V-00379-01
Encounter Date: 01/03/2002
Last: Padilla
First: Luz elena
DOB: 02/22/1965
County: Cobb
Street: 3999 Verbena Dr.
City: Kenesaw
State: GA

Zip

30144-

Cell

(770) 896-7292

Family Status

Two parent family w/children

COB

Mexico

Gender

Female

Housing

Single Family

Education Level

Some College

Home Owner

YES

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: J. Perez
Data Entry: S. Aviña