Pancho - GON-EUS-70

Code: GON-EUS-70
Mercy ID: V-02833-02
Encounter Date: 07/01/2008
Last: Gonzalez
First: Eusebio
DOB: 06/27/1970
County: Gwinnett
Street: 2874 Wildflower lane
City: Snellville
State: GA

Zip

30039-

Cell

(770) 896-2483

Family Status

Single adult

COB

Mexico

Gender

Male

Housing

Other

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: 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