LOP-MAR-71

Code
LOP-MAR-71
Mercy ID
V-00089-01
Encounter Date
11/15/2005
Last
Lopez
First
Maria estela
DOB
11/15/1971
County
Gwinnett
Street
3208 Lia Hilla Drive
City
Norcross
State
GA
Zip
30071-
Home
(678) 732-7363
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Arellano
First
Mariano
DOB
N/A
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
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
Bernardo Arellano 06/07/1995 Mother GA/USA
Cecilia Arellano 03/10/1994 Mother GA/USA
Dileny Arellano 07/17/1991 Mother GA/USA
Fortino Arellano 03/15/2003 Mother GA/USA
Leonardo Arellano 05/28/1990 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By
Fabiola Gomez