Pancho - SER-JOS-77

Code: SER-JOS-77
Mercy ID: V-01795-02
Encounter Date: 12/28/2004
Last: Serrato
First: Jose julian
DOB: 09/29/1977
County: Gwinnett
Street: 3214 Valley Blass Dr.
City: Doraville
State: GA

Zip

30340-

Home

(404) 969-9837

Family Status

Single adult

COB

Mexico

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: F. Perez
Data Entry: K. Aleman