Pancho - MEN-ANG-64

Code: MEN-ANG-64
Mercy ID: V-01269-02
Encounter Date: 07/01/2003
Last: Mendoza vazquez
First: Angel
DOB: 07/28/1964
County: Dekalb
Street: 3137 Moss Oak Dr.
City: Doraville
State: GA

Zip

30340-

Home

(770) 729-0754

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Adult, no formal education

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