Pancho - DEL-HIL-68

Code: DEL-HIL-68
Mercy ID: V-00542-02
Encounter Date: 06/26/2001
Last: De la rosa
First: Hilario
DOB: 02/29/1968
County: Cherokee
Street: 6901 Heritage Place
City: Woodstock
State: GA

Zip

30102-

Home

(770) 592-2786

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Other

Education Level

Grade school

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: K. Aleman