Pancho - BUS-WIL-83

Code: BUS-WIL-83
Mercy ID: V-02571-02
Encounter Date: 04/29/2008
Last: Bustamante
First: William
DOB: 12/22/1983
County: Dekalb
Street: 4499 Lawrenceville
City: Tucker
State: GA

Zip

30084-

Cell

(770) 820-3106

Family Status

Adult couple-no children

COB

Honduras

Gender

Male

Housing

Single Family

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