VAL-RAF-66

Code
VAL-RAF-66
Mercy ID
V-00052-02
Encounter Date
02/16/1999
Last
Valdez
First
Rafael
DOB
10/24/1966
County
Cobb
Street
1700 Air Craft Dr.
City
Marietta
State
GA
Zip
30060-
Home
(770) 434-0279
Cell
(678) 260-8123
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
Vocational/Technical

Spouse Information

Last
Valdez
First
Margarita
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
YES
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
Daniela Valdez N/A Parents GA/USA
Evelyn Valdez N/A Parents GA/USA
Hugo Valdez N/A 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