Pancho - CAU-GLO-84

Code: CAU-GLO-84
Mercy ID: V-00039-11
Encounter Date: 12/02/1998
Last: Campusano
First: Gloria
DOB: 07/26/1984
County: Fulton
Street: 1190 Lowe Lane
City: Roswell
State: GA

Zip

30076-

Home

(770) 518-6936

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Rosa Taboada	01/04/1968	Mexico
Father	Patricio Campusano	03/17/1963	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Roswell HS
Grade: 9th.
Who Can't Pickup the Child: SOLO LA MAMA LA PUEDE RECOGER
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Manzo
Data Entry: J. Manzo