Pancho - RAB-EZE-73

Code: RAB-EZE-73
Mercy ID: V-01367-02
Encounter Date: 09/30/2003
Last: Rabadan
First: Ezequiel
DOB: 08/10/1973
County: Dekalb
Street: 4715 Buford Hwy Apt C
City: Chamblee
State: GA

Zip

30341-

Home

(770) 454-0261

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