Pancho - FLO-BLA-93

Code: FLO-BLA-93
Mercy ID: V-02745-12
Encounter Date: 03/26/2008
Last: Flores
First: Blanca
DOB: 09/15/1993
County: Fulton
Street: 2780 Cheryl Drive Apt. # 3
City: East point
State: GA

Zip

30344-

Cell

(678) 973-5977

Family Status

Child/Youth

COB

Mexico

Gender

Female Child

Housing

Single Family

Education Level

some high school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Guadalupe Montes	07/01/1965	Mexico
Father	Antonio Flores	08/19/1964	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Trade City H.S.
Grade: 9th.
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