BER-NOR-59

Code
BER-NOR-59
Mercy ID
V-01489-01
Encounter Date
02/18/2004
Last
Berrocales
First
Norma
DOB
02/10/1959
County
Gwinnett
Street
912 Sparrows Ln.
City
Norcross
State
GA
Zip
30093-
Home
(770) 939-2126
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Santo
First
Orlando
DOB
10/29/1950
Address
N/A
Telephone
N/A
COB
Cuba
Home Owner
No
Driver
No
Home Owner
YES
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
Edward Vega 09/22/1989 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
x1375 Damaryz