NAR-OFE-68

Code
NAR-OFE-68
Mercy ID
V-01490-01
Encounter Date
02/17/2004
Last
Narciso
First
Ofelia
DOB
04/02/1968
County
Fulton
Street
518 King Arnold
City
Atlanta
State
GA
Zip
30354-
Home
(404) 477-0286
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Valente mendoza
First
Mariel
DOB
03/09/1967
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
Alfredo Valente Mendoza 06/20/1989 Mother GA/USA
Jacqueline Valente Mendoza 09/30/1986 Aunt Mexico
NOTES
she signed the "promesa de confidencialidad" and "consentimiento para…" form as Ofelia Mendoza; and she put her son's name as Jose Alfredo Valente.

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