Pancho - FLO-ANG-03

Code: FLO-ANG-03
Mercy ID: V-00953-11
Encounter Date: 03/29/2004
Last: Flores
First: Angela
DOB: 08/27/2003
County: Hall
Street: 5565 Mulberry St. Apt. A-S
City: Flowery branch
State: GA

Zip

30542-

Cell

(678) 887-2941

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Susana Ventura	08/10/1973	Mexico
Father	Marco Flores	06/13/1977	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Flowery Branch
Grade: 1st.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: YES
Limitado Caminar Latino: No

Intake: K. Aleman
Data Entry: K. Aleman