Code
TEL-KEN-09
Mercy ID
V-03126-11
Encounter Date
12/31/2009
Last
Tellez
First
Kentra
DOB
10/03/2009
County
Gwinnett
Street
6308 Dunleaf Arc Way
City
Norcross
State
GA
Zip
30093-
Cell
(678) 508-7063
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
Child, not in school
Home Owner
YES

Parents Information

Name DOB COB
Mother Elvia Rodriguez 02/25/1983 Mexico
Father Ivan Tellez 01/16/1983 Mexico
Step Parent N/A N/A N/A
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Parents
Name of School
N/A
Grade
N/A
Who Can't Pickup the Child

Media

NO DOY PERMISO
Authoritation Parent
YES
Authoritation Child
No
DOY PERMISO
No
Limitado Educativo
YES
Limitado Impresos
No
Limitado Caminar Latino
YES
Intake
G. Landeros
Data Entry
J. Manzo