Code
MEN-LET-71
Mercy ID
V-01148-01
Encounter Date
03/07/2003
Last
Mendoza
First
Leticia
DOB
10/24/1971
County
Dekalb
Street
3711 Bufford Hwy Apt. 7
City
Atlanta
State
GA
Zip
30329-
Home
(678) 508-4269
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Figueroa
First
Jose
DOB
N/A
Address
N/A
Telephone
N/A
COB
Honduras
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
Gustavo Cerecero 12/07/1991 Mother w/Stepfather GA/USA
Jaime Cerecero 01/01/1988 Mother w/Stepfather GA/USA
Jonathan Mendoza 09/13/1997 Mother w/Stepfather 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