Code
VIL-OMA-72
Mercy ID
V-01086-02
Encounter Date
01/29/2003
Last
Villanueva
First
Omar
DOB
06/24/1972
County
Fulton
Street
3300 College St.
City
College park
State
GA
Zip
30337-
Home
(404) 767-2658
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Barajas
First
Judith
DOB
10/03/1970
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
No
Driver License Date
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
Omar Villanueva 05/28/1995 Parents GA/USA
Victor Alejandro 06/28/2001 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
K. Aleman
Referred By