VEL-ARC-80

Code
VEL-ARC-80
Mercy ID
V-00777-01
Encounter Date
12/18/2001
Last
Velazquez
First
Arcedalia
DOB
03/24/1980
County
Gwinnett
Street
4162 Creck Hollow Way
City
Duluth
State
GA
Zip
30096-
Home
(770) 840-8641
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Urbina
First
Jose oscar
DOB
11/01/1979
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
Cesar Urbina 09/27/2003 Parents GA/USA
Oscar Mauricio Urbina 03/17/2002 Parents GA/USA
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
x7764 Michelle