ROD-MAR-76

Code
ROD-MAR-76
Mercy ID
V-01569-01
Encounter Date
04/08/2004
Last
Rodriguez
First
Martha
DOB
12/22/1976
County
Gwinnett
Street
651 Stonewall Court
City
Stone mountain
State
GA
Zip
30087-
Cell
(678) 755-4886
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Evelyn Lopez 10/27/2004 Mother GA/USA
Kevin Lopez 12/13/2000 Mother GA/USA
Osvaldo Lopez 02/25/2003 Mother GA/USA

Former Spouse 1 Information

Last
Lopez
First
Jose manuel
DOB
05/19/1974
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES
Entro al cell de Griselda. En el 2010.

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
Radio 610: Sisi Castillo (La Hora de los adolorido