Pancho - MEN-ROL-71

Code: MEN-ROL-71
Mercy ID: V-01957-02
Encounter Date: 07/12/2005
Last: Mendoza
First: Rolando
DOB: 06/28/1971
County: Gwinnett
Street: 1647 Erick Circle
City: Lawrenceville
State: GA

Zip

30043-

Cell

(404) 583-1182

Family Status

Adult coupie-no children

COB

Perú

Gender

Male

Housing

Not Homeless

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: F. Perez
Data Entry: K. Aleman