PAC-ISA-76

Code
PAC-ISA-76
Mercy ID
V-01863-01
Encounter Date
04/01/2005
Last
Pacheco
First
Isabel
DOB
01/18/1976
County
Gwinnett
Street
2410 Windsor Wood Apt F
City
Norcross
State
GA
Zip
30071-
Home
(770) 448-3194
Cell
(404) 246-0649
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Analco
First
Francisco
DOB
12/03/1972
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
No
Stranger
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Owen Analco 02/04/2004 Parents GA/USA
Tomas Analco 08/03/2000 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
Rafael Miranda