ROM-ELB-66

Code
ROM-ELB-66
Mercy ID
V-01060-01
Encounter Date
12/17/2002
Last
Romero
First
Elba
DOB
05/21/1966
County
Gwinnett
Street
703 Mideaw Woods Pl
City
Norcross
State
GA
Zip
30071-
Home
(770) 441-9859
Cell
(770) 798-9285
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Torres
First
Manuel
DOB
06/21/1974
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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Dalinda Leticia Romero 03/28/1993 Grandmother GA/USA
Mauricio Romero 08/23/1990 Grandmother GA/USA
Xenia Jaeli Torres 08/28/2000 Parents GA/USA
NOTES
Telephone#2 is Gabriela's #--A friend

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
Y. Garcia
Referred By
Rebeca 7764