Pancho - POR-ROD-71

Code: POR-ROD-71
Mercy ID: V-00767-02
Encounter Date: 12/11/2001
Last: Portillo
First: Rodolfo
DOB: 06/21/1971
County: Fulton
Street: 5735 Roswell Rd.
City: Atlanta
State: GA

Zip

30342-

Home

(404) 943-0910

Cell

(404) 252-7347

Family Status

Adult coupie-no children

COB

Mexico

Gender

Male

Housing

Doubling Up

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: K. Aleman