LOP-AND-73

Code
LOP-AND-73
Mercy ID
V-01245-01
Encounter Date
05/31/2003
Last
Lopez
First
Andrea
DOB
11/02/1973
County
Cobb
Street
421 Lakeview Dr.
City
Marietta
State
GA
Zip
30062-
Home
(770) 528-9167
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Lopez
First
Israel
DOB
10/25/1972
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
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
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
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
Arely Lopez 08/21/1999 Parents GA/USA
Eder Lopez 02/05/1995 Parents GA/USA
Ilianda Lopez 02/07/2001 Parents GA/USA
Oneida Lopez 06/23/1992 Parents GA/USA
Yolanda Lopez 10/10/1996 Parents 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