Pancho - COR-MIC-65

Code: COR-MIC-65
Mercy ID: V-00088-02
Encounter Date: 02/16/2000
Last: Cordero
First: Michael
DOB: 10/25/1965
County: Fulton
Street: 1505 chattahooche ave#80
City: Atlanta
State: GA

Zip

30318-

Home

(770) 435-2007

Family Status

Two parent family w/children

COB

Puerto Rico

Gender

Male

Housing

Not Homeless

Education Level

College Degree

Home Owner

YES

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: D. Gomez