Pancho - OGA-ERI-64

Code: OGA-ERI-64
Mercy ID: V-02257-02
Encounter Date: 07/10/2006
Last: Ogando
First: Eriberto
DOB: 02/24/1964
County: Gwinnett
Street: 3715 Aristrocat Ct.
City: Loganville
State: GA

Zip

30052-

Cell

(404) 578-2026

Family Status

Single adult

COB

Dominican Rep

Gender

Male

Housing

Doubling Up

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: J. Manzo