Pancho - RAM-APO-61

Code: RAM-APO-61
Mercy ID: V-02147-02
Encounter Date: 01/24/2006
Last: Ramirez
First: Apolonio
DOB: 09/17/1961
County: Dekalb
Street: 2505 Van Fleet Circle
City: Atlanta
State: GA

Zip

30360-

Home

(770) 452-8198

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Preschool

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