Pancho - SAL-EDE-69

Code: SAL-EDE-69
Mercy ID: V-00769-02
Encounter Date: 12/11/2001
Last: Salado
First: Eder
DOB: 04/19/1969
County: Fulton
Street: 300 Carpenter Apt. D-12
City: Atlanta
State: GA

Zip

30328-

Home

(404) 822-8008

Cell

(404) 843-8212

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

some high 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