CRU-IRI-69

Code
CRU-IRI-69
Mercy ID
V-02126-01
Encounter Date
12/23/2005
Last
Cruz
First
Iris armelia
DOB
01/17/1969
County
Dekalb
Street
32 Clardiew Dr.
City
Chamblee
State
GA
Zip
30341-
Home
(404) 437-9711
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Ortiz
First
Victor
DOB
06/08/1968
Address
N/A
Telephone
N/A
COB
El Salvador
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
Alson Julianne 01/29/2004 Mother GA/USA
Marco Tulio Suazo 12/20/1990 Father GA/USA
Rosalba Magdabna Ortiz 04/09/2005 Mother GA/USA
Tony Rodimir Suarzo 08/02/1992 Aunt Guatemala
Yeizon Suazo 09/26/1988 Father GA/USA

Former Spouse 1 Information

Last
Suazo
First
Marco tulio
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