ALC-FER-64

Code
ALC-FER-64
Mercy ID
V-01092-02
Encounter Date
04/29/1998
Last
Alcocer
First
Fernando
DOB
02/23/1964
County
Dekalb
Street
3610 Buford Hwy Apt. B3
City
Atlanta
State
GA
Zip
30329-
Home
(404) 728-9219
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Other
Education Level
Other

Spouse Information

Last
Espinoza
First
Lourdes
DOB
N/A
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
Fernando N/A N/A GA/USA
Marcos N/A N/A GA/USA
Omar N/A N/A GA/USA
Rodrigo N/A N/A 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