Pancho - REY-FLO-77

Code: REY-FLO-77
Mercy ID: V-00710-01
Encounter Date: 10/03/2001
Last: Reyes
First: Florida
DOB: 05/25/1977
County: Gwinnett
Street: 3115 Cruce Rd.
City: Lawrencevill
State: GA

Zip

30044-

Home

(770) 381-5382

Family Status

Single adult

COB

El Salvador

Gender

Female

Housing

Doubling Up

Education Level

Grade school

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: 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