Pancho - GAL-FRA-53

Code: GAL-FRA-53
Mercy ID: V-02212-02
Encounter Date: 04/03/2006
Last: Gallegos
First: Francisco a
DOB: 01/04/1953
County: Gwinnett
Street: 827 Ridge Trl
City: Duluth
State: GA

Zip

30096-

Home

(404) 578-4922

Family Status

Single adult

COB

Colombia

Gender

Male

Housing

Doubling Up

Education Level

H.S. equivalency diploma

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