Pancho - VAL-RAF-66

Code: VAL-RAF-66
Mercy ID: V-00052-02
Encounter Date: 02/16/1999
Last: Valdez
First: Rafael
DOB: 10/24/1966
County: Cobb
Street: 1700 Air Craft Dr.
City: Marietta
State: GA

Zip

30060-

Home

(770) 434-0279

Cell

(678) 260-8123

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Single Family

Education Level

Vocational/Technical

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