Pancho - ART-FER-71

Code: ART-FER-71
Mercy ID: V-00392-02
Encounter Date: 01/23/2001
Last: Arteaga
First: Fermin
DOB: 07/07/1971
County: Cherokee
Street: 507 e 2nd ap1
City: Rome
State: GA

Zip

30316-

Home

(706) 232-0401

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: S. Aviña