CAB-ROS-41

Code
CAB-ROS-41
Mercy ID
V-01346-01
Encounter Date
09/11/2003
Last
Cobo
First
Rosalba
DOB
10/15/1941
County
Gwinnett
Street
1100 Riverside Walk Crossing
City
Norcross
State
GA
Zip
30518-
Home
(678) 482-8106
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Castro
First
Jose
DOB
N/A
Address
N/A
Telephone
N/A
COB
Other
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
YES
Stranger
No

Former Spouse 1 Information

Last
Mejia
First
Guillermo
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No
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