Pancho - MER-CEL-68

Code: MER-CEL-68
Mercy ID: B-00007-02
Encounter Date: 01/01/1999
Last: Mercado
First: Celedonio
DOB: 05/03/1968
County: Not given
Street: 2722 Herodia Cir. Apt. 8
City: Smyrna
State: GA

Zip

30080-

Home

(770) 541-0423

Cell

(770) 437-9181

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

Education Level

High school graduate

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: F. Perez
Data Entry: Y. Garcia