PER-CAR-71

Code
PER-CAR-71
Mercy ID
V-00888-01
Encounter Date
04/08/2002
Last
Perez
First
Carmen
DOB
08/16/1971
County
Rockdale
Street
21 Elcar Way
City
Conyers
State
GA
Zip
30012-
Home
(678) 413-9448
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Perez
First
Irleis
DOB
08/30/1958
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
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
Abigail Perez 06/29/1991 N/A GA/USA
Carlos Perez 05/12/2000 N/A GA/USA
Carmen Perez 05/04/1998 N/A GA/USA
Roberto Perez 02/03/2002 N/A 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 Ma Eugenia