Pancho - OLV-TIM-68

Code: OLV-TIM-68
Mercy ID: V-00853-02
Encounter Date: 03/05/2002
Last: Olvera
First: Timoteo
DOB: 05/05/1968
County: Gwinnett
Street: 5625 Wylake Dr.
City: Norcross
State: GA

Zip

30093-

Home

(770) 564-9370

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

some high school

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: R. Miranda
Data Entry: K. Aleman