HER-MAR-72

Code
HER-MAR-72
Mercy ID
V-00023-01
Encounter Date
01/17/2000
Last
Hernandez
First
Maria concepcion
DOB
08/28/1972
County
Cobb
Street
431 collett ave
City
Mableton
State
GA
Zip
30126-
Home
(770) 944-2413
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Vega
First
Salomon
DOB
12/16/1972
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
No
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
ana itza 01/26/1999 Parents GA/USA
jonathan 05/16/1997 Parents GA/USA
jorge miguel 04/20/1992 Parents GA/USA
karla 12/13/1989 Parents 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