ESP-OCT-72

Code
ESP-OCT-72
Mercy ID
V-00121-02
Encounter Date
02/21/2000
Last
Espinoza
First
Octavio
DOB
07/18/1972
County
Other
Street
2390 Fairburn Rd.
City
Douglasville
State
GA
Zip
30135-
Home
(678) 838-9394
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Hernandez
First
Alma
DOB
02/28/1976
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Amy Espinoza 07/14/1998 Parents GA/USA
Andrea Espinoza 06/11/1995 Father w/Stepmother GA/USA
Jovanna Hernandez 08/07/1993 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
Y. Garcia
Referred By