TAP-CRI-78

Code
TAP-CRI-78
Mercy ID
V-01763-01
Encounter Date
11/23/2004
Last
Tapia
First
Cristina
DOB
03/19/1978
County
Fulton
Street
4689 Roswell Rd. Apt L8
City
Atlanta
State
GA
Zip
30342-
Home
(404) 303-0153
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Cortina
First
Jesus
Middle
A.
DOB
12/15/1979
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
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
Cindel Mojica Tapia 10/23/1995 Mother w/Stepfather GA/USA
Jose de Jesus Mojica 09/27/1994 Mother w/Stepfather 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
Rafael Miranda