Pancho - CAS-VIC-74

Code: CAS-VIC-74
Mercy ID: V-02913-02
Encounter Date: 01/26/2009
Last: Castro
First: Vicente
DOB: 07/19/1974
County: Cherokee
Street: 7829 Midway Rd.
City: Alpharetta
State: GA

Zip

30004-

Home

(678) 947-6016

Cell

(770) 480-1800

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Single Family

Education Level

High school graduate

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