MEJ-LET-67

Code
MEJ-LET-67
Mercy ID
V-01797-01
Encounter Date
01/07/2005
Last
Mejia cruz
First
Leticia
DOB
06/23/1967
County
Fulton
Street
62 Harwell Rd. NW Apt B-4
City
Atlanta
State
GA
Zip
30311-
Home
(404) 696-2230
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Adult, no formal education

Spouse Information

Last
Rosas
First
Mario
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
Estrella Jose 08/06/2000 Mother GA/USA
Laura Rojas 04/14/1991 Mother GA/USA
Leticia Rosas 05/13/1990 Mother GA/USA
Mario Alberto Rosas 03/21/1993 Mother 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