Pancho - DIA-OSC-85

Code: DIA-OSC-85
Mercy ID: V-02072-02
Encounter Date: 09/27/2005
Last: Diaz
First: Oscar
DOB: 12/06/1985
County: Fulton
Street: 723 Morosgo NE H16
City: Atlanta
State: GA

Zip

30324-

Home

(678) 732-6471

Family Status

Adult coupie-no children

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: R. Miranda
Data Entry: R. Gonzalez