Pancho - VAC-ROB-65

Code: VAC-ROB-65
Mercy ID: V-00281-02
Encounter Date: 09/11/2000
Last: Vaca
First: Roberto
DOB: 01/20/1965
County: Fulton
Street: 4729 Buford Hwy. Apt H
City: Chamblee
State: GA

Zip

30341-

Home

(770) 216-9932

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

Education Level

Preschool

Home Owner

YES

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: Y. Garcia