Pancho - ROM-ARM-68

Code: ROM-ARM-68
Mercy ID: V-00781-02
Encounter Date: 07/05/2005
Last: Romero
First: Armando
DOB: 06/09/1968
County: Fulton
Street: 2203 Plaster Rd. Apt E11
City: Atlanta
State: GA

Zip

30345-

Home

(404) 447-3404

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