Pancho - WHI-DAN-73

Code: WHI-DAN-73
Mercy ID: V-00189-02
Encounter Date: 04/25/2000
Last: White
First: Daniel
DOB: 03/12/1973
County: Fulton
Street: 1015 caliber spring way ne
City: Atlanta
State: GA

Zip

30342-

Home

(404) 231-3080

Family Status

Adult coupie-no children

COB

Nicaragua

Gender

Male

Housing

Doubling Up

Education Level

Preschool

Home Owner

YES

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: R. Miranda
Data Entry: S. Aviña