Pancho - PER-MAU-73

Code: PER-MAU-73
Mercy ID: V-02172-02
Encounter Date: 02/21/2006
Last: Perez
First: Mauricio
DOB: 05/05/1973
County: Cobb
Street: 1245 Brandl Dr.
City: Marietta
State: GA

Zip

30008-

Cell

(404) 438-0895

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

some high school

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: YES
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: R. Miranda
Data Entry: R. Gonzalez