Pancho - LEP-EDG-72

Code: LEP-EDG-72
Mercy ID: V-01264-02
Encounter Date: 05/15/2006
Last: Lep
First: Edgar
DOB: 05/08/1972
County: Dekalb
Street: 3743 Turner Heights Dr
City: Decatur
State: GA

Zip

30032-

Home

(404) 534-1378

Cell

(404) 840-9642

Family Status

Two parent family w/children

COB

Guatemala

Gender

Male

Housing

Other

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: F. Perez
Data Entry: R. Gonzalez