Pancho - RIZ-MIG-54

Code: RIZ-MIG-54
Mercy ID: V-02236-02
Encounter Date: 05/08/2006
Last: Rizo
First: Miguel
DOB: 10/07/1954
County: Fulton
Street: 29 Peachtree Avenue #2
City: Atlanta
State: GA

Zip

30305-

Cell

(404) 447-8697

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