ROD-MAR-12

Code
ROD-MAR-12
Mercy ID
V-02066-01
Encounter Date
10/19/2005
Last
Rodrigues
First
Maria de lourdes
DOB
12/24/1973
County
Dekalb
Street
3600 Shallowford Rd. C-3
City
Doraville
State
GA
Zip
30341-
Cell
(678) 365-7326
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Rodrigues
First
Russell
DOB
06/01/1978
Address
N/A
Telephone
N/A
COB
USA
Home Owner
No
Driver
No
Home Owner
YES
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
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
Edgar Bustos Rodrigues 06/04/2003 Mother GA/USA
Fernando Bustos Rodrigues 03/20/1999 Mother GA/USA
Jesus E. Rodriguez 04/04/2006 Mother GA/USA
NOTES
Another women has the same code, so I used this women's birth month as the last 2 digits of the code.

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By