VAZ-ERI-75

Code
VAZ-ERI-75
Mercy ID
V-01093-01
Encounter Date
01/22/2003
Last
Vazquez
First
Erika
DOB
06/17/1975
County
Fulton
Street
3375 Aztec Dr. Apt. 42
City
Doraville
State
GA
Zip
30340-
Home
(770) 986-4118
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Diaz
First
Jose
DOB
08/16/1968
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Erick Diaz 09/23/1994 Mother GA/USA
Jose David Diaz 01/11/1993 Mother GA/USA
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
x3737 Damaryz