Pancho - PAL-LUI-76

Code: PAL-LUI-76
Mercy ID: V-02343-02
Encounter Date: 10/24/2006
Last: Palacio
First: Luis
DOB: 08/29/1976
County: Fulton
Street: 11302 Magnolia Pointe Blvd.
City: Duluth
State: GA

Zip

30096-

Cell

(678) 457-2883

Family Status

Single adult

COB

Colombia

Gender

Male

Housing

Doubling Up

Education Level

Post Grad 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: J. Manzo
Data Entry: J. Manzo