LOP-VIC-75

Code
LOP-VIC-75
Mercy ID
V-01028-02
Encounter Date
11/12/2002
Last
Lopez aguilar
First
Victor manuel
DOB
11/13/1975
County
Dekalb
Street
15 Chatfield Dr. Apt C
City
Stone mountain
State
GA
Zip
30083-
Home
(678) 937-1729
Family Status
Adult coupie-no children
COB
Guatemala
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Contreras ramos
First
Hilda
DOB
10/28/1965
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
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
Dekalb County