Pancho - CAR-VIC-69

Code: CAR-VIC-69
Mercy ID: V-02489-02
Encounter Date: 05/21/2007
Last: Caro
First: Vicente
DOB: 08/12/1969
County: Gwinnett
Street: not given
City: Atlanta
State: GA

Zip

99999-

Cell

(678) 977-3078

Family Status

Single adult

COB

Mexico

Gender

Male

Housing

Transitional

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

Intake: J. Manzo
Data Entry: J. Manzo