Pancho - GAT-ELB-77

Code: GAT-ELB-77
Mercy ID: V-00247-02
Encounter Date: 07/18/2000
Last: Gatica
First: Elber
DOB: 04/18/1977
County: Fulton
Street: 2127 Vineyard Walk Apt. 7
City: Atlanta
State: GA

Zip

30316-

Cell

(404) 783-6469

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Single Family

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: R. Miranda
Data Entry: D. Gomez