Pancho - YAN-JOS-73

Code: YAN-JOS-73
Mercy ID: V-00424-02
Encounter Date: 12/05/2001
Last: Yañez
First: Jose
DOB: 11/27/1973
County: Fulton
Street: 5735 Roswell Rd. Apt. 411
City: Roswell
State: GA

Zip

30347-

Home

(404) 250-1394

Family Status

Two parent family w/children

COB

Mexico

Gender

Male

Housing

Not Homeless

Education Level

Adult, no formal education

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: F. Perez
Data Entry: K. Aleman