Pancho - VEG-CON-66

Code: VEG-CON-66
Mercy ID: V-00083-02
Encounter Date: 02/16/2000
Last: Vega
First: Constantino
DOB: 05/10/1966
County: Fulton
Street: 3315 roswell rd ne #b5
City: Atlanta
State: GA

Zip

30328-

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Grade 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: S. Aviña