Pancho - PER-JUA-79

Code: PER-JUA-79
Mercy ID: V-03227-02
Encounter Date: 07/27/2010
Last: Perez
First: Juan angel
DOB: 04/24/1979
County: Clayton
Street: 307 Hemmingway Place
City: Riverdale
State: GA

Zip

30274-

Cell

(770) 572-1143

Family Status

Single adult

COB

Mexico

Gender

Male

Housing

Single Family

Education Level

Some College

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