Pancho - RES-EDW-81

Code: RES-EDW-81
Mercy ID: V-01986-02
Encounter Date: 08/23/2005
Last: Restrepo
First: Edwin
DOB: 02/06/1981
County: Dekalb
Street: 1614 Brookview Ave
City: Doraville
State: GA

Zip

30340-

Home

(404) 484-4863

Family Status

Single adult

COB

Mexico

Gender

Male

Housing

Doubling Up

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