Pancho - EST-GLO-72

Code: EST-GLO-72
Mercy ID: V-01838-01
Encounter Date: 02/18/2005
Last: Estrada
First: Gloria
DOB: 04/01/1972
County: Gwinnett
Street: 4595 Rosemear Cr.
City: Norcross
State: GA

Zip

30093-

Home

(678) 768-7743

Cell

(770) 935-9589

Family Status

Single parent w/children

COB

Mexico

Gender

Female

Housing

Transitional

Education Level

some high school

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: G. Landeros
Data Entry: K. Aleman