ELO-SOF-65

Code
ELO-SOF-65
Mercy ID
V-01868-01
Encounter Date
03/21/2005
Last
Elorza
First
Sofia
DOB
08/23/1965
County
Other
Street
6961 Richard Lane
City
Austell
State
GA
Zip
30168-
Home
(770) 675-4382
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Preschool

Spouse Information

Last
Elorza
First
Pedro
DOB
01/08/1965
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
Ana Elorza 12/22/2000 Parents GA/USA
Emely Elorza 01/24/2000 Parents GA/USA
Pedro Elorza 01/10/2004 Parents 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