Code
ROJ-ANT-59
Mercy ID
V-02100-02
Encounter Date
01/24/2006
Last
Rojas
First
Antonio
DOB
05/08/1959
County
Fulton
Street
4594 Puchett St.
City
Forest park
State
GA
Zip
30297-
Home
(404) 361-2114
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Post Grad Degree

Spouse Information

Last
Alberto
First
Minerva
DOB
02/22/1966
Address
N/A
Telephone
(404) 361-2114
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Adriana Rojas 01/14/1994 Parents GA/USA
Antonio Jr Rojas 04/17/1992 Parents GA/USA
Demetria Rojas 12/22/1988 Parents GA/USA
Irene Rojas 01/04/1998 Parents GA/USA
NOTES

Media Authoritation

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