Pancho - GAR-ADO-74

Code: GAR-ADO-74
Mercy ID: V-02102-02
Encounter Date: 12/13/2005
Last: Garcia maya
First: Adolfo
DOB: 04/28/1974
County: Dekalb
Street: 3214 Pulley Bluff Dr.
City: Doraville
State: GA

Zip

30340-

Home

(678) 887-7756

Cell

(678) 732-6767

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Other

Education Level

Grade 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: R. Gonzalez