Pancho - PAC-MAR-79

Code: PAC-MAR-79
Mercy ID: V-02122-02
Encounter Date: 12/27/2005
Last: Pacheco ramirez
First: Marco
DOB: 09/11/1979
County: Fulton
Street: 3210 Metheson Ave
City: Atlanta
State: GA

Zip

30327-

Cell

(404) 447-3143

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Other

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: R. Gonzalez