Pancho - RUB-ISR-83

Code: RUB-ISR-83
Mercy ID: V-01672-02
Encounter Date: 08/17/2004
Last: Rubio
First: Israel
DOB: 05/29/1983
County: Fulton
Street: 84 Guillingham Apt #1
City: Hapeville
State: GA

Zip

30354-

Home

(404) 762-7063

Family Status

Adult coupie-no children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Preschool

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