Pancho - SAN-ROG-68

Code: SAN-ROG-68
Mercy ID: V-00274-02
Encounter Date: 08/22/2000
Last: Sandoval
First: Rogelio
DOB: 09/16/1968
County: Fulton
Street: 839 Tahoe Dr
City: Roswell
State: GA

Zip

30076-

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Doubling Up

Education Level

some high 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: R. Miranda
Data Entry: D. Gomez