GAL-JUA-58

Code
GAL-JUA-58
Mercy ID
V-00530-02
Encounter Date
05/22/2001
Last
Galvan
First
Juan
DOB
05/30/1958
County
Fulton
Street
1291 clermont ave
City
Eastpoint
State
GA
Zip
30344-
Home
(404) 766-5272
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school
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
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
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