Pancho - RUI-HON-76

Code: RUI-HON-76
Mercy ID: V-00258-02
Encounter Date: 08/08/2000
Last: Ruiz
First: Honorio
DOB: 12/30/1976
County: Clayton
Street: 685 melrose dr
City: Forestpark
State: GA

Zip

30297-

Home

(404) 627-0486

Family Status

Two parent family w/children

COB

El Salvador

Gender

Male

Housing

Doubling Up

Education Level

some high 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