PAC-CRI-73

Code
PAC-CRI-73
Mercy ID
V-02041-01
Encounter Date
09/15/2005
Last
Pacheco
First
Cristina
DOB
07/05/1973
County
Gwinnett
Street
5932 Morgan Rd.
City
Doraville
State
GA
Zip
30340-
Cell
(770) 866-7255
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Anahi M. Pacheco 07/07/1999 Grandmother Mexico-Maternos
Jesse Pacheco 08/06/2004 Grandmother Mexico-Maternos

Former Spouse 1 Information

Last
Pacheco
First
Raul
DOB
04/29/1969
Telephone
N/A
COB
Mexico
Home Owner
YES
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
R. Gonzalez
Referred By