Pancho - UMA-CAR-55

Code: UMA-CAR-55
Mercy ID: V-02191-02
Encounter Date: 03/02/2006
Last: Umaña
First: Carlos
DOB: 11/25/1955
County: Gwinnett
Street: 3203 Park Colony Dr
City: Norcross
State: GA

Zip

30093-

Home

(770) 875-5375

Family Status

Two parent family w/children

COB

El Salvador

Gender

Male

Housing

Doubling Up

Education Level

Preschool

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