Pancho - CAR-ANT-75

Code: CAR-ANT-75
Mercy ID: V-00976-02
Encounter Date: 07/16/2002
Last: Cardoso
First: Marco antonio
DOB: 10/03/1975
County: Fulton
Street: 338 Wood Creek Ct.
City: Roswell
State: GA

Zip

30076-

Home

(678) 357-7936

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: K. Aleman