Pancho - MOR-VAL-90

Code: MOR-VAL-90
Mercy ID: V-02948-02
Encounter Date: 11/18/2008
Last: Moreno
First: Valentin
DOB: 02/14/1990
County: Fulton
Street: 2748 Third Ave.
City: Atlanta
State: GA

Zip

30315-

Cell

(404) 569-7559

Family Status

Single adult

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: 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