NEG-YOL-77

Code
NEG-YOL-77
Mercy ID
V-01477-01
Encounter Date
02/04/2004
Last
Negrete
First
Yolanda
DOB
08/02/1977
County
Fulton
Street
150 Willow St.
City
Roswell
State
GA
Zip
00000-0000
Home
(770) 843-5004
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
De la cruz
First
Fernando
DOB
07/28/1965
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Charlie De la Cruz 02/23/2002 Parents GA/USA
Fernando Jr. De la Cruz 04/01/1990 Parents GA/USA
Miguel Angel De la Cruz 05/28/1995 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By