Pancho - SIL-CES-81

Code: SIL-CES-81
Mercy ID: V-01919-02
Encounter Date: 06/27/2005
Last: Franco
First: Carlos
DOB: 05/22/1981
County: Cobb
Street: 1250 Pinehurts Cir.
City: Smyrna
State: GA

Zip

30080-

Cell

(404) 944-4216

Family Status

Two parent family w/children

COB

Perú

Gender

Male

Housing

Single Family

Education Level

High school graduate

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