Pancho - OLV-CAR-72

Code: OLV-CAR-72
Mercy ID: V-01675-02
Encounter Date: 09/21/2004
Last: Olvera
First: Carlos
DOB: 02/23/1972
County: Fulton
Street: 5801 Kingsport Ave
City: Atlanta
State: GA

Zip

30342-

Home

(678) 410-8905

Family Status

Two parent family w/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