Pancho - FLO-TER-68

Code: FLO-TER-68
Mercy ID: V-01031-01
Encounter Date: 11/12/2002
Last: Flores
First: Teresa
DOB: 06/25/1968
County: Gwinnett
Street: 855 Hill Crest Rd. NW
City: Lilburn
State: GA

Zip

30047-

Home

(404) 423-8276

Family Status

Two parent family w/children

COB

Nicaragua

Gender

Female

Housing

Doubling Up

Education Level

College Degree

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: J. Manzo
Data Entry: K. Aleman