Pancho - GAR-HER-49

Code: GAR-HER-49
Mercy ID: V-01013-02
Encounter Date: 09/24/2002
Last: Garcia
First: Heriberto
DOB: 05/02/1949
County: Other
Street: 125 Northwood Dr. 320
City: Atlanta
State: GA

Zip

30342-

Home

(404) 840-7131

Cell

(678) 523-4028

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

Education Level

Adult, no formal education

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
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: K. Aleman