LAR-BEL-51

Code
LAR-BEL-51
Mercy ID
V-00465-01
Encounter Date
04/04/2001
Last
Lara
First
Belia
DOB
07/09/1951
County
Gwinnett
Street
2150 new berry rd
City
Norcross
State
GA
Zip
30071-
Home
(770) 263-9572
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
juan manuel mendoza 01/15/1969 Adulto/Casado GA/USA
ma. De lourdes 02/22/1972 N/A GA/USA
rigoberto mendoza 11/29/1972 N/A GA/USA
tony reinarldo lara 12/14/1990 N/A GA/USA
veronica mendoza 05/30/1970 Adulto/Soltero california
wendy mendoza 11/19/1978 N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
S. Aviña
Referred By