VID-ROS-72

Code
VID-ROS-72
Mercy ID
V-01847-01
Encounter Date
03/08/2005
Last
Vidal
First
Rosana
DOB
05/15/1972
County
Fulton
Street
436 Norcross
City
Roswell
State
GA
Zip
30076-
Home
(770) 641-1531
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Doubling Up
Education Level
Child, not in school

Spouse Information

Last
Cazene
First
Pablo
DOB
02/02/1977
Address
N/A
Telephone
N/A
COB
Uruguay
Home Owner
YES
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Antonella Cazene N/A N/A 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
K. Aleman
Referred By