Pancho - PAU-GAB-63

Code: PAU-GAB-63
Mercy ID: V-00540-02
Encounter Date: 09/11/2001
Last: Puac
First: Gabino
DOB: 03/13/1963
County: Cherokee
Street: 551 Longview Rd.
City: Canton
State: GA

Zip

30114-

Home

(678) 493-9791

Family Status

Two parent family w/children

COB

Guatemala

Gender

Male

Housing

Doubling Up

Education Level

Preschool

Home Owner

No

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: R. Miranda
Data Entry: S. Aviña