Pancho - TAR-MAN-72

Code: TAR-MAN-72
Mercy ID: V-00362-02
Encounter Date: 12/05/2000
Last: Tarango
First: Manuel
DOB: 07/25/1972
County: Dekalb
Street: 1331 nortncliff valley apt d
City: Atlanta
State: GA

Zip

30319-

Home

(404) 327-7752

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Other

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: K. Aleman
Data Entry: S. Aviña