CAR-ANA-72

Code
CAR-ANA-72
Mercy ID
V-01715-01
Encounter Date
09/22/2004
Last
Carreon
First
Ana
DOB
07/03/1972
County
Gwinnett
Street
2893 Beaverly Cove
City
Bufford
State
GA
Zip
30518-
Home
(770) 614-2630
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical

Spouse Information

Last
Robles
First
Jose
DOB
01/21/1970
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
No
Consentimiento De Participar
No

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
Magali Robles 12/25/2002 Mother GA/USA
Ricardo Robles 09/28/1996 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
Damaryz