HER-ISI-74

Code
HER-ISI-74
Mercy ID
V-01949-01
Encounter Date
06/28/2005
Last
Hernandez
First
Isis areli
DOB
07/11/1974
County
Dekalb
Street
3593 Meadowglenn #E
City
Doraville
State
GA
Zip
30340-
Home
(404) 447-7412
Family Status
Single adult
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Ramirez
First
Jose humberto
DOB
N/A
Address
N/A
Telephone
N/A
COB
Guatemala
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
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Angela Rebeca Hernandez 04/18/2004 Grandmother Honduras
Christian Cruz 05/11/1994 Grandmother Honduras
Moises Hernandez 01/10/2002 Grandmother Honduras
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