COR-IRA-82

Code
COR-IRA-82
Mercy ID
V-01968-01
Encounter Date
07/09/2005
Last
Correa
First
Irais
DOB
05/02/1982
County
Rockdale
Street
1389-B Irwin Britt
City
Conyers
State
GA
Zip
30012-
Home
(678) 508-8460
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Colin
First
Dimas
DOB
09/11/1979
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
Angel Colin 10/15/2004 Mother GA/USA
Ixel Dimas Colin 10/17/2000 Mother GA/USA
Janet Colin 11/13/2002 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By