TEL-JAS-93

Code
TEL-JAS-93
Mercy ID
V-03160-11
Encounter Date
09/02/2009
Last
Tello
First
Jasmine
DOB
10/10/1993
County
Cobb
Street
48 Oxford Road
City
Marietta
State
GA
Zip
30008-
Cell
(678) 334-3663
Family Status
Child/Youth
COB
USA
Gender
Female Child
Housing
Single Family
Education Level
some high school
Home Owner
YES

Parents Information

Name DOB COB
Mother Noemi Rodriguez 08/15/1976 Mexico
Father Jose Juan Tello 02/24/1974 Mexico
Step Parent Moises Rodriguez 05/17/1974 Nicaragua
Driver
No
Relative
No
Stranger
No
NOTES
Lives With
Mother
Name of School
Osborn H.S.
Grade
10th.
Who Can't Pickup the Child

Media

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