COR-ELV-70

Code
COR-ELV-70
Mercy ID
V-01633-01
Encounter Date
06/16/2004
Last
Cornejo
First
Elvira
DOB
01/25/1970
County
Other
Street
295 Foller Rd.
City
Alpharetta
State
GA
Zip
30004-
Home
(678) 442-0285
Cell
(404) 388-0682
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
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
No
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
Angelica Cornejo 06/13/1987 Mother GA/USA
Lizbella Cornejo 09/22/1996 Mother GA/USA
Miguel Angel Cornejo 09/07/1990 Mother GA/USA
Rigoberto Cornejo 07/12/1988 Mother 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