Pancho - BAH-JOS-67

Code: BAH-JOS-67
Mercy ID: V-00689-02
Encounter Date: 04/02/1999
Last: Bahena
First: Jose
DOB: 11/30/1967
County: Dekalb
Street: 3135 bufford hwy apt 3
City: Atlanta
State: GA

Zip

30324-

Home

(404) 329-0638

Family Status

Single parent 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: F. Perez
Data Entry: S. Aviña