Pancho - FLO-ADR-72

Code: FLO-ADR-72
Mercy ID: V-03356-01
Encounter Date: 07/06/2010
Last: Flores
First: Adriana
DOB: 03/10/1972
County: Gwinnett
Street: 1035 Hill Creek Road
City: Lilburn
State: GA

Zip

30047-

Cell

(678) 548-1831

Family Status

Two parent family w/children

COB

Colombia

Gender

Female

Housing

Doubling Up

Education Level

Post Grad Degree

Home Owner

YES

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: J. Manzo