Pancho - CRU-PED-82

Code: CRU-PED-82
Mercy ID: V-02639-02
Encounter Date: 11/20/2007
Last: Cruz
First: Pedro
DOB: 10/03/1982
County: Dekalb
Street: 6911 Kerrie Way
City: Lithonia
State: GA

Zip

30058-

Cell

(404) 379-9853

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Grade 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: YES
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. Perez
Data Entry: G. Landeros