Pancho - FEL-KEL-74

Code: FEL-KEL-74
Mercy ID: V-02196-02
Encounter Date: 03/20/2006
Last: Feliz
First: Kelvin antonio
DOB: 05/20/1974
County: Cobb
Street: 2550 Akers Mill Rd.
City: Atlanta
State: GA

Zip

30339-

Home

(770) 618-2898

Cell

(404) 484-0381

Family Status

Two parent family w/children

COB

Dominican Rep

Gender

Male

Housing

Other

Education Level

College Degree

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