Pancho - AGU-JAV-71

Code: AGU-JAV-71
Mercy ID: V-02049-02
Encounter Date: 12/13/2005
Last: Aguilar
First: Javier
DOB: 05/08/1971
County: Dekalb
Street: 3086 Jet drive
City: Doraville
State: GA

Zip

30340-

Cell

(404) 401-9242

Family Status

Adult coupie-no children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

Some College

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: R. Gonzalez