SAN-JOS-70

Code
SAN-JOS-70
Mercy ID
V-02413-02
Encounter Date
04/17/2007
Last
Sandoval
First
Jose luis
DOB
09/12/1970
County
Fulton
Street
13016 Gardner Dr.
City
Alpharetta
State
GA
Zip
30004-
Home
(770) 521-9531
Cell
(678) 549-6461
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
College Degree
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
NOTES
Lives With
N/A
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
No
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
No
Limitado Impresos
No
Limitado Caminar Latino
No
Intake
J. Manzo
Data Entry
J. Manzo