Pancho - CAN-RAU-68

Code: CAN-RAU-68
Mercy ID: V-00868-02
Encounter Date: 08/13/2002
Last: Canchola
First: Raul
DOB: 07/03/1968
County: Dekalb
Street: 1460 North Cliff Valley Way D
City: Atlanta
State: GA

Zip

30319-

Home

(404) 931-8132

Family Status

Two parent family w/children

COB

USA

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