CAN-RAU-68

Code
CAN-RAU-68
Mercy ID
V-00868-02
Encounter Date
08/13/2002
Last
Canchola
First
Raul
DOB
07/03/1968
County
Dekalb
Street
1460 North Cliff Valley Way D
City
Atlanta
State
GA
Zip
30319-
Home
(404) 931-8132
Family Status
Two parent family w/children
COB
USA
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Bernal
First
Maria
DOB
10/31/1975
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
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
Christian N/A N/A GA/USA
Daisy Jackelyn N/A N/A GA/USA
Daniel N/A N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By
Voluntario