Pancho - HER-VIC-90

Code: HER-VIC-90
Mercy ID: O-00003-02
Encounter Date: 02/19/2003
Last: Herrera
First: Victor
DOB: 07/05/1990
County: Fulton
Street: 5801 Kingsports Dr. Apt. 248 Bld 7
City: Atlanta
State: GA

Zip

30342-

Home

(404) 438-4071

Cell

(404) 668-3913

Family Status

Single adult

COB

USA

Gender

Male

Housing

Single Family

Education Level

High school graduate

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: Y. Garcia
Data Entry: K. Aleman