Pancho - FLO-MAR-02

Code: FLO-MAR-02
Mercy ID: V-02014-16
Encounter Date: 04/12/2006
Last: Flores
First: Martha
DOB: 08/20/2002
County: Dekalb
Street: 3612 Morning Size Vella
City: Doraville
State: GA

Zip

30340-

Home

(678) 458-1909

Cell

(678) 508-9897

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Bianca Flores	08/14/1972	Mexico
Father	Selvin Flores	01/31/1980	El Salvador
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Head Start
Grade: Pre-K
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: R. Gonzalez
Data Entry: R. Gonzalez