VEL-ANG-78

Code
VEL-ANG-78
Mercy ID
V-00582-01
Encounter Date
11/20/2001
Last
Velasquez
First
Angela
DOB
10/02/1978
County
Cobb
Street
6771 Landmarck Way 14-C
City
Austell
State
GA
Zip
30168-
Home
(770) 944-1780
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Diaz
First
Noel
DOB
08/30/1976
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
Cristofer Anderson Diaz 07/10/2001 Parents GA/USA
Fatima Velasquez 06/08/1999 Grandmother El Salvador
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
Ma. Eugenia x7764