Pancho - ESP-FER-70

Code: ESP-FER-70
Mercy ID: V-01679-02
Encounter Date: 09/14/2004
Last: Espinoza
First: Fernando
DOB: 09/27/1970
County: Gwinnett
Street: 1133 Riverridge Dr.
City: Norcross
State: GA

Zip

30093-

Home

(678) 933-7144

Family Status

Adult coupie-no 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