Pancho - VAL-LEO-69

Code: VAL-LEO-69
Mercy ID: V-01595-02
Encounter Date: 04/11/2004
Last: Valente rodriguez
First: Leonor
DOB: 04/03/1969
County: Fulton
Street: 2431 Morosgo Way Apt B
City: Atlanta
State: GA

Zip

30324-

Home

(404) 264-9086

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

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: R. Miranda
Data Entry: K. Aleman