Pancho - MER-CES-74

Code: MER-CES-74
Mercy ID: V-03114-02
Encounter Date: 07/14/2009
Last: Mercado
First: Cesar
DOB: 01/13/1974
County: Dekalb
Street: 2300 Global Forum Blvd. # 523
City: Doraville
State: GA

Zip

30340-

Home

(678) 927-4974

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