Pancho - MOR-FER-72

Code: MOR-FER-72
Mercy ID: B-00023-02
Encounter Date: 10/07/1996
Last: Morales
First: Fernando
DOB: 04/26/1972
County: Other
Street: 532 Cleveland Ave Apt 32H
City: Atlanta
State: GA

Zip

33315-

Home

(000) 266-8700

Family Status

Adult coupie-no children

COB

Mexico

Gender

Male

Housing

Other

Education Level

Other

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: J. Manzo
Data Entry: K. Aleman