Pancho - CUE-UBA-70

Code: CUE-UBA-70
Mercy ID: V-01440-02
Encounter Date: 12/16/2003
Last: Cuevas
First: Ubaldo
DOB: 05/16/1970
County: Fulton
Street: 390 Irwin St. HA 11
City: Atlanta
State: GA

Zip

30312-

Home

(404) 522-3188

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