PER-ALI-75

Code
PER-ALI-75
Mercy ID
V-01140-01
Encounter Date
03/07/2003
Last
Perez
First
Alicia
DOB
06/14/1975
County
Dekalb
Street
3659 Buford Hwy B-8
City
Atlanta
State
GA
Zip
30329-
Home
(404) 633-3612
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Alva
First
Israel
DOB
11/12/1973
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
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
Edwin Alva 10/12/1996 Mother w/Stepfather GA/USA
Michelle Alva 11/12/1994 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Cervantes
First
Pedro
DOB
11/12/1973
Telephone
N/A
COB
N/A
Home Owner
No
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