Pancho - RAM-ALF-69

Code: RAM-ALF-69
Mercy ID: V-02166-02
Encounter Date: 02/14/2006
Last: Ramos
First: Alfonso
DOB: 04/05/1969
County: Dekalb
Street: 1589 Scaantonay
City: Clearwater
State: GA

Zip

33756-

Home

(678) 471-7833

Family Status

Two parent family w/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