VAR-ROS-47

Code
VAR-ROS-47
Mercy ID
V-01047-01
Encounter Date
10/11/2002
Last
Varela
First
Rosa
DOB
08/19/1947
County
Fulton
Street
1381 Custer Ave. A-6
City
Atlanta
State
GA
Zip
30316-
Home
(678) 754-1954
Family Status
Adult coupie-no children
COB
Nicaragua
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Claro
First
Nicomedes
DOB
N/A
Address
N/A
Telephone
N/A
COB
El Salvador
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
J. Manzo
Data Entry
K. Aleman
Referred By