Pancho - ALV-KEN-04

Code: ALV-KEN-04
Mercy ID: V-03470-22
Encounter Date: 11/03/2010
Last: Alvarez
First: Kenneth
DOB: 07/16/2004
County: Gwinnett
Street: 3355 Sweetwater Rd. Apt. 8108
City: Lawrenceville
State: GA

Zip

30044-

Cell

(678) 663-4843

Family Status

Child/Youth

COB

USA

Gender

Male Child

Housing

Single Family

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	Dolores Santos	07/28/1977	Dominican Rep
Father	N/A	N/A	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: Corler Elem.
Grade: 1st.
Who Can't Pickup the Child
Authoritation Parent: YES
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: J. Manzo