Pancho - SUA-BRA-70

Code: SUA-BRA-70
Mercy ID: V-00132-02
Encounter Date: 02/09/2000
Last: Suarez
First: Braulio
DOB: 07/16/1970
County: Cobb
Street: 933 milstone dr
City: Marietta
State: GA

Zip

30062-

Home

(770) 579-5468

Family Status

Single parent w/children

COB

USA

Gender

Male

Housing

Not Homeless

Education Level

Some College

Home Owner

YES

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: S. Aviña