Pancho - GAL-OSN-74

Code: GAL-OSN-74
Mercy ID: V-01543-02
Encounter Date: 03/23/2004
Last: Gallardo
First: Osniel
DOB: 04/27/1974
County: Cobb
Street: 3670 Lakewood Ct.
City: Marietta
State: GA

Zip

30066-

Home

(678) 516-5823

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