HER-TER-69

Code
HER-TER-69
Mercy ID
V-02102-01
Encounter Date
11/29/2005
Last
Hernandez
First
Teresa
DOB
05/21/1969
County
Dekalb
Street
3497 Meadowglen Village Ln
City
Doraville
State
GA
Zip
30340-
Cell
(678) 887-7756
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Garcia
First
Adolfo
DOB
04/28/1974
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
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
Antonio de Jesus Rueda 11/25/2001 Mother w/Stepfather GA/USA
Maria G. Rueda Hernandez 02/08/1994 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Rueda
First
Antonio
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No
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
Walk in