MOR-MAR-69

Code
MOR-MAR-69
Mercy ID
V-02020-01
Encounter Date
09/06/2005
Last
Moreno fuentes
First
Maria de la paz
DOB
01/20/1969
County
Fulton
Street
2214 Plaster Rd. #C
City
Atlanta
State
GA
Zip
00000-0000
Home
(404) 636-0272
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Other
Education Level
Grade school

Spouse Information

Last
Rodriguez
First
Francisco
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
YES
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
Bisney Rodriguez 09/09/1993 Father El Salvador
Evelyn Rodriguez Morena 08/13/1988 Mother GA/USA
Jimmy A. Rodriguez 05/12/1992 Father El Salvador
Johny Rodriguez 02/09/2002 Father El Salvador
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