MON-XIO-75

Code
MON-XIO-75
Mercy ID
V-01289-01
Encounter Date
07/18/2003
Last
Monteon
First
Xiomara
DOB
08/06/1975
County
Gwinnett
Street
1390 Turtler Dove
City
Lawrenceville
State
GA
Zip
30046-
Home
(770) 822-5669
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical

Spouse Information

Last
Delao
First
Paulo
DOB
05/06/1974
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
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
Camila Delao 12/12/2002 Mother GA/USA
Ivan Delao 06/14/2001 Mother 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