ROD-PIL-69

Code
ROD-PIL-69
Mercy ID
V-00514-01
Encounter Date
09/27/2002
Last
Rodriguez
First
Pilar
DOB
01/09/1969
County
Clayton
Street
7735 Tara Blvd. Lot D19
City
Jonesboro
State
GA
Zip
30236-
Home
(770) 477-6408
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Maldonado
First
Carlos
DOB
02/16/1977
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Brenda 10/25/1990 Mother GA/USA
Carlos Manuel 05/08/1989 Mother GA/USA
Julio 07/24/1992 Mother 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
K. Aleman
Referred By
SJMC Francisco de la Fuente