Pancho - SAL-RON-77

Code: SAL-RON-77
Mercy ID: V-01071-02
Encounter Date: 12/17/2002
Last: Salaz
First: Ronny
DOB: 05/15/1977
County: Cobb
Street: 254 Clave Dr.
City: Marietta
State: GA

Zip

30060-

Home

(770) 792-4438

Family Status

Adult coupie-no children

COB

Honduras

Gender

Male

Housing

Not Homeless

Education Level

Grade 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: K. Aleman