Pancho - TAF-JOR-60

Code: TAF-JOR-60
Mercy ID: V-01713-02
Encounter Date: 11/09/2004
Last: Taffur
First: Jorge
DOB: 08/07/1960
County: Dekalb
Street: 3323 Valley Broock Place
City: Decatur
State: GA

Zip

30033-

Home

(404) 477-1225

Family Status

Single adult

COB

Perú

Gender

Male

Housing

Doubling Up

Education Level

some high 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