MEN-YOL-71

Code
MEN-YOL-71
Mercy ID
V-01639-01
Encounter Date
06/23/2004
Last
Mendoza
First
Yolanda
DOB
07/19/1971
County
Gwinnett
Street
1040 Omaja Dr.
City
Norcross
State
GA
Zip
30093-
Home
(770) 931-3301
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Mendoza
First
Ulises
DOB
02/18/1969
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Johana N/A N/A GA/USA
Liliana N/A N/A GA/USA
Sulman N/A N/A GA/USA
Ulises N/A 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
Damaryz