Pancho - YEJ-VLA-75

Code: YEJ-VLA-75
Mercy ID: V-00094-02
Encounter Date: 02/16/2000
Last: Yeje
First: Vladimir
DOB: 11/25/1975
County: Fulton
Street: 6985 Roswell Rd.
City: Sandy springs
State: GA

Zip

30328-

Home

(770) 396-8291

Family Status

Two parent family w/children

COB

Dominican Rep

Gender

Male

Housing

Not Homeless

Education Level

some high school

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: Y. Garcia