Code
LOP-JUA-77
Mercy ID
V-00880-01
Encounter Date
03/20/2002
Last
Lopez
First
Juana
DOB
02/06/1977
County
Dekalb
Street
3409 Cumberland Court
City
Doraville
State
GA
Zip
30340-
Home
(770) 455-8517
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

Spouse Information

Last
Lucas mendoza
First
Rolando
DOB
N/A
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
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Boby Lucas 10/29/2001 Mother 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