PER-JOS-76

Code
PER-JOS-76
Mercy ID
V-00087-02
Encounter Date
02/29/2000
Last
Perez
First
Jose antonio
DOB
10/26/1976
County
Fulton
Street
2044 down la nw
City
Atlanta
State
GA
Zip
30318-
Home
(404) 355-4089
Family Status
Single adult
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
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Perilla
Data Entry
D. Gomez