LAZ-ROS-76

Code
LAZ-ROS-76
Mercy ID
V-00024-01
Encounter Date
01/05/2000
Last
Lazo
First
Rosa
DOB
08/17/1976
County
Fulton
Street
6945 Roswell Rd Apt-F
City
Atlanta
State
GA
Zip
30328-
Home
(770) 913-0181
Family Status
Two parent family w/children
COB
El Salvador
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Del valle
First
Juan
Middle
M.
DOB
09/29/1979
Address
same03
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
Mark Anthony Del Valle 08/24/1999 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
D. Gomez
Referred By