Pancho - ZAC-FIL-64

Code: ZAC-FIL-64
Mercy ID: B-00010-02
Encounter Date: 01/08/1999
Last: Zacahua
First: Filiberto
DOB: 08/22/1964
County: Fulton
Street: 1353 N Cift Valley Way
City: Atlanta
State: GA

Zip

30319-

Home

(404) 633-2355

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Grade 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: F. Perez
Data Entry: Y. Garcia