MEL-RAU-64

Code
MEL-RAU-64
Mercy ID
V-00118-02
Encounter Date
02/08/2000
Last
Melchor
First
Raul
DOB
07/10/1964
County
Gwinnett
Street
1156 forest valley way #e1
City
Norcross
State
GA
Zip
30093-
Home
(678) 380-4645
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Some College

Spouse Information

Last
Arrieta
First
Martha
DOB
12/02/1968
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
eder 10/04/1991 Father GA/USA
karla 11/03/1987 Mother GA/USA
raul 01/06/1989 Father GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
F. Perez
Data Entry
S. Aviña
Referred By