Pancho - ALA-RAF-68

Code: ALA-RAF-68
Mercy ID: V-02839-02
Encounter Date: 09/16/2008
Last: Alarcon
First: Rafael
DOB: 11/27/1968
County: Gwinnett
Street: 2500 Pleasant Hill Road
City: Duluth
State: GA

Zip

30360-

Home

(770) 896-1730

Family Status

Single adult

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: J. Manzo
Data Entry: J. Manzo