Code
CRU-GEO-68
Mercy ID
V-01150-01
Encounter Date
03/10/2003
Last
Cruz
First
Georgina
DOB
05/10/1968
County
Dekalb
Street
3008 Winspring Hill
City
Chamblee
State
GA
Zip
30341-
Home
(770) 451-0965
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Bargona
First
Reynaldo
DOB
01/06/1975
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
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
YES
Driver License Date
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
Efren Hernandez 06/05/1988 Mother w/Stepfather GA/USA
Gloria Alejandra 04/17/1992 Mother w/Stepfather GA/USA
Maria Victoria Hernandez 11/17/1987 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. Perez
Data Entry
K. Aleman
Referred By
x3737 Damaryz