ROD-MAR-70

Code
ROD-MAR-70
Mercy ID
V-01326-01
Encounter Date
08/29/2003
Last
Rodriguez
First
Maria del pilar
DOB
11/24/1970
County
Gwinnett
Street
4575 Ahwather Ct.
City
Buford
State
GA
Zip
30518-
Home
(404) 519-7984
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Ortega
First
Eduardo
DOB
10/22/1973
Address
N/A
Telephone
N/A
COB
Colombia
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
YES
Consentimiento De Participar
YES

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
Mateo Ortega 06/20/1997 N/A GA/USA
Nicolas Ortega 06/20/1997 N/A 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