MOR-YAD-75

Code
MOR-YAD-75
Mercy ID
V-01333-01
Encounter Date
09/02/2003
Last
Lopez
First
Yadira
DOB
08/04/1975
County
Gwinnett
Street
3280 Simview Ct.
City
Snellville
State
GA
Zip
30078-
Home
(770) 931-3315
Cell
(770) 572-7764
Family Status
Two parent family w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Morales
First
Carlos
DOB
04/17/1969
Address
N/A
Telephone
N/A
COB
Guatemala
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Carlos Ariel Morales 08/06/2001 N/A GA/USA
Christopher Morales 07/07/1995 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
x3737 Damaryz