Pancho - SAN-JES-83

Code: SAN-JES-83
Mercy ID: V-03020-02
Encounter Date: 03/03/2009
Last: Santana
First: Jesus
DOB: 04/30/1983
County: Dekalb
Street: 1617 Briarwood Road Apt. B
City: Atlanta
State: GA

Zip

30319-

Cell

(770) 375-9422

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: 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