Pancho - TEL-RIC-00

Code: TEL-RIC-00
Mercy ID: V-00876-21
Encounter Date: 03/27/2002
Last: Telomico
First: Richard
DOB: 12/12/2000
County: Dekalb
Street: 3852 McElroy Apt. A1
City: Doraville
State: GA

Zip

30340-

Home

(678) 547-0521

Family Status

Attached youth

COB

Mexico

Gender

Male Child

Housing

Doubling Up

Education Level

Child, not in school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Norma Cortez	05/02/1975	Mexico
Father	Ricardo Telomico	02/07/1976	Mexico
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: Y. Garcia
Data Entry: K. Aleman