Pancho - MEJ-CAR-74

Code: MEJ-CAR-74
Mercy ID: V-02101-02
Encounter Date: 11/29/2005
Last: Mejia
First: Carlos mario
DOB: 05/24/1974
County: Dekalb
Street: 2017 Oak Shadow Court
City: Atlanta
State: GA

Zip

30318-

Home

(404) 399-1393

Family Status

Adult coupie-no children

COB

El Salvador

Gender

Male

Housing

Doubling Up

Education Level

Adult, no formal education

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: R. Gonzalez