Pancho - CRU-GLO-02

Code: CRU-GLO-02
Mercy ID: V-02662-12
Encounter Date: 03/19/2008
Last: Cruz
First: Gloria
DOB: 12/19/2002
County: Gwinnett
Street: 6534 Hilldale Dr. Apt. G
City: Norcross
State: GA

Zip

30092-

Home

(678) 368-1325

Family Status

Child/Youth

COB

USA

Gender

Female Child

Housing

Doubling Up

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Erasta Cruz	01/18/1978	Mexico
Father	Enrique Cruz	07/24/1979	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: The Petite
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: C. Martinez
Data Entry: J. Manzo