MOR-JUD-65

Code
MOR-JUD-65
Mercy ID
V-00722-01
Encounter Date
10/24/2001
Last
Mora mendoza
First
Judith
DOB
03/12/1965
County
Dekalb
Street
Chamblee Hights
City
Chamblee
State
GA
Zip
00000-0000
Home
(000) 000-0000
Cell
(000) 000-0000
Family Status
Single adult
COB
Puerto Rico
Gender
Female
Housing
Street
Education Level
some high school

Spouse Information

Last
Perez
First
Roger
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
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