VEG-BLA-64

Code
VEG-BLA-64
Mercy ID
V-01781-01
Encounter Date
12/14/2004
Last
Vega
First
Blanca
DOB
10/26/1964
County
Fulton
Street
5735 Roswell Rd. Apt 22
City
Atlanta
State
GA
Zip
30042-
Cell
(678) 768-4803
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Delgado
First
Honecimo
DOB
02/15/1961
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
Brenda Delgado 09/23/1989 Parents GA/USA
Dalia Delgado 09/09/1994 Parents GA/USA
Daniela Delgado 03/28/1984 Parents GA/USA
Perla Delgado 04/12/1982 Parents 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