HER-DON-76

Code
HER-DON-76
Mercy ID
V-01869-01
Encounter Date
03/22/2005
Last
Hernandez
First
Dona lilia
DOB
08/05/1976
County
Cobb
Street
1500 Bellemeade #168
City
Marietta
State
GA
Zip
30008-
Home
(678) 355-9219
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Luna
First
Erasmo
DOB
07/02/1980
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
Alejandro Luna 08/19/2001 Parents GA/USA
Cristian Luna 07/24/1999 Parents GA/USA
Yasmin Luna 01/20/1998 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