Pancho - COR-ELI-70

Code: COR-ELI-70
Mercy ID: B-00018-02
Encounter Date: 07/03/1998
Last: Cortes
First: Eliseo
DOB: 06/14/1970
County: Other
Street: not given
City: Not given
State: GA

Zip

N/A

Home

(770) 992-6359

Family Status

Adult coupie-no children

COB

Mexico

Gender

Male

Housing

Other

Education Level

Other

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