Pancho - DEL-JUA-79

Code: DEL-JUA-79
Mercy ID: V-00024-02
Encounter Date: 02/16/2000
Last: Del valle
First: Juan miguel
DOB: 09/29/1979
County: Fulton
Street: 6945 Roswell Rd Apt-F
City: Atlanta
State: GA

Zip

30328-

Home

(770) 913-0181

Family Status

Two parent family w/children

COB

El Salvador

Gender

Male

Housing

Not Homeless

Education Level

High school graduate

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: D. Gomez