MON-NOR-65

Code
MON-NOR-65
Mercy ID
V-01355-01
Encounter Date
09/18/2003
Last
Monsalvo
First
Nora
DOB
01/02/1965
County
Gwinnett
Street
6493 Pleasendale Rd. Apt. A-1
City
Doravile
State
GA
Zip
30340-
Home
(770) 559-4500
Cell
(770) 846-6097
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Vocational/Technical

Spouse Information

Last
Monsalvo
First
David
DOB
09/14/1964
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
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
Cesar Monsalvo 04/03/1997 Mother GA/USA
Kevin Monsalvo 10/10/2001 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
K. Aleman
Referred By
x3737 Damaryz