Pancho - VIL-OMA-72

Code: VIL-OMA-72
Mercy ID: V-01086-02
Encounter Date: 01/29/2003
Last: Villanueva
First: Omar
DOB: 06/24/1972
County: Fulton
Street: 3300 College St.
City: College park
State: GA

Zip

30337-

Home

(404) 767-2658

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

Education Level

Some College

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