BAR-ROS-70

Code
BAR-ROS-70
Mercy ID
B-00008-01
Encounter Date
09/03/1999
Last
Barrera
First
Rosa
DOB
11/27/1970
County
Not given
Street
1353 Clssvall Lake apt. G
City
Chamblee
State
GA
Zip
30319-
Home
(404) 634-5273
Family Status
Unknow/Unreported
COB
Other
Gender
Female
Housing
Other
Education Level
Grade school

Spouse Information

Last
Zacahua
First
Filiberto
DOB
08/22/1964
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
Luis F. 05/29/1995 Mother Ga/usa
Reynaldo 01/06/1998 Grandmother Mexico
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
Y. Garcia
Referred By