Pancho - MAG-EVE-71

Code: MAG-EVE-71
Mercy ID: V-01625-02
Encounter Date: 06/08/2004
Last: Magaña
First: Everardo
DOB: 03/04/1971
County: Dekalb
Street: 4939 Oakdale Apt 9K
City: Smyrna
State: GA

Zip

30080-

Home

(678) 768-1838

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