Pancho - CER-VIC-70

Code: CER-VIC-70
Mercy ID: V-00082-02
Encounter Date: 06/24/1999
Last: Cerda
First: Victor
DOB: 07/28/1970
County: Fulton
Street: 1388 Custer Ave.
City: Dekalb
State: GA

Zip

30316-

Home

(404) 624-9610

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: F. Perez
Data Entry: Y. Garcia