Pancho - TEO-KEV-01

Code: TEO-KEV-01
Mercy ID: V-03062-21
Encounter Date: 04/29/2009
Last: Teodoro
First: Kevin
DOB: 05/05/2001
County: Dekalb
Street: 2205 Briarcliff Rd. Apt. 19
City: Atlanta
State: GA

Zip

30329-

Cell

(404) 447-0384

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Maria Vargas	02/11/1983	Mexico
Father	Antonio Teodoro	01/14/1978	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Briarcliff Elem.
Grade: 2nd.
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: C. Martinez
Data Entry: J. Manzo