Pancho - SUA-DAV-76

Code: SUA-DAV-76
Mercy ID: V-02110-02
Encounter Date: 01/03/2006
Last: Suarez
First: David
DOB: 04/03/1972
County: Dekalb
Street: 1750 Briarwood Rd Apt H
City: Atlanta
State: GA

Zip

30329-

Cell

(678) 973-8439

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

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