LOP-VIR-65

Code
LOP-VIR-65
Mercy ID
V-01437-01
Encounter Date
12/08/2003
Last
Lopez
First
Virginia
DOB
06/04/1965
County
Gwinnett
Street
3270 Sir Gregory Manor
City
Lawrenceville
State
GA
Zip
30044-
Cell
(678) 848-7978
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Lopez
First
Ramiro
DOB
08/23/1964
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Jonathan Lopez 12/12/1994 Parents GA/USA
Max Lopez 12/22/1997 Parents GA/USA
Ramiro Lopez 01/05/1999 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Miranda
Referred By
x3737 damaryz