Pancho - HER-CAR-73

Code: HER-CAR-73
Mercy ID: V-00085-02
Encounter Date: 02/15/2000
Last: Hernandez
First: Carlos
DOB: 12/16/1973
County: Dekalb
Street: 1506 Winters Creek Dr. Apt. D
City: Doraville
State: GA

Zip

30360-

Home

(678) 966-0979

Family Status

Adult coupie-no 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: R. Miranda
Data Entry: Y. Garcia