COB-OLG-78

Code
COB-OLG-78
Mercy ID
V-01926-01
Encounter Date
05/26/2005
Last
Cobos
First
Olga
DOB
06/16/1978
County
Clayton
Street
7878 Northmain St. #28
City
Jonesboro
State
GA
Zip
00000-00
Home
(678) 548-7553
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Alcantara
First
Eliseo
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
No
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
Eliseo Alcantara 04/22/1999 Parents GA/USA
Elizabeth Alcantara 05/26/1996 Parents GA/USA
Juan Manuel Alcantara 12/31/1994 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