Pancho - FLO-MIC-03

Code: FLO-MIC-03
Mercy ID: V-02575-11
Encounter Date: 08/15/2007
Last: Flores
First: Michell
DOB: 02/09/2003
County: Gwinnett
Street: 329 Freeport Drive
City: Lawrenceville
State: GA

Zip

30045-

Cell

(678) 760-3592

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Cynthia Hernandez	07/21/1980	Mexico
Father	Fernando Flores	04/15/1978	Mexico
Step Parent	Jose Borja	09/22/1984	Mexico

Driver: No
Relative: No
Stranger: No
Lives With: Mother w/Stepfather
Name of School: Lawrenceville elem
Grade: Kinder
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo