Pancho - MEN-FRE-83

Code: MEN-FRE-83
Mercy ID: V-00315-02
Encounter Date: 02/13/2001
Last: Mendoza
First: Fredy
DOB: 12/22/1983
County: Fulton
Street: 367east place ferry rd Ap B-11
City: Atlanta
State: GA

Zip

30305-

Home

(404) 841-9919

Family Status

Two parent family w/children

COB

Mexico

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