LAG-MAR-68

Code
LAG-MAR-68
Mercy ID
V-01252-01
Encounter Date
06/20/2003
Last
Lagos
First
Maria
DOB
01/08/1968
County
Gwinnett
Street
3267 Buford Hwy 720 Suite
City
Atlanta
State
GA
Zip
30339-
Home
(678) 557-2532
Family Status
Single adult
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Lagos
First
Luis
DOB
01/18/1963
Address
N/A
Telephone
N/A
COB
Honduras
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Luis Michelle Acosta 03/15/1990 Father 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 Rafa/Juana