Pancho - GAR-ELI-75

Code: GAR-ELI-75
Mercy ID: V-00096-02
Encounter Date: 02/11/2000
Last: Garcia
First: Elias
DOB: 04/19/1975
County: Fulton
Street: 831 Tahoe North Apt. J
City: Roswell
State: GA

Zip

30076-

Home

(678) 525-1975

Family Status

Two parent family w/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: Y. Garcia