COR-ANA-72

Code
COR-ANA-72
Mercy ID
V-00859-01
Encounter Date
03/06/2002
Last
Coria
First
Ana
DOB
07/25/1972
County
Forsyth
Street
2560 Bufford Dam Rd.
City
Cumming
State
GA
Zip
30041-
Home
(770) 888-5659
Cell
(678) 755-6339
Work
(770) 844-8363
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Alberto
First
Pablo
DOB
06/29/1960
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Alberto Alberto 06/01/1998 Parents GA/USA
Karla Alberto 09/01/1996 Parents GA/USA
Pablo Alejandro Alberto 03/13/1982 Father w/Stepmother 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
K. Aleman
Referred By
x7764 Ma. Eugenia