Pancho - ROS-FEL-81

Code: ROS-FEL-81
Mercy ID: V-01565-02
Encounter Date: 04/20/2004
Last: Rosales
First: Felipe
DOB: 04/04/1981
County: Fulton
Street: 925 Conley Rd. Apt 1
City: Atlanta
State: GA

Zip

30354-

Home

(404) 366-8488

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