BOL-VER-70

Code
BOL-VER-70
Mercy ID
V-00767-01
Encounter Date
12/11/2001
Last
Bolaños
First
Veronica
DOB
10/18/1970
County
Fulton
Street
5735 Roswell Rd. Apt. 306
City
Atlanta
State
GA
Zip
30342-
Home
(404) 943-0910
Cell
(770) 390-0047
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Portillo
First
Rodolfo
DOB
06/21/1971
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
YES
Consentimiento De Participar
YES

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
Luis E. Vega 04/06/1992 Grandparents Mexico
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
x7764 Maria Eugenia