MOR-SAN-84

Code
MOR-SAN-84
Mercy ID
V-02097-01
Encounter Date
11/18/2005
Last
Morales
First
Sandra
DOB
11/26/1984
County
Dekalb
Street
5030 Westmountain St. Apt 56
City
Stone mountain
State
GA
Zip
30083-
Home
(770) 469-1839
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Ramirez
First
Fernando
DOB
06/12/1979
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
Diego Armando Ramirez 01/03/2005 Parents Mexico
Mayeni Fernanda Ramirez 06/06/2003 Parents Mexico
NOTES

Media Authoritation

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