Pancho - REY-EZE-82

Code: REY-EZE-82
Mercy ID: V-01134-02
Encounter Date: 04/29/2003
Last: Reyes
First: Ezequiel
DOB: 09/10/1982
County: Other
Street: 3381 Lavista Dr.
City: Hapeville
State: GA

Zip

30354-

Home

(404) 761-3255

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