PER-ALB-63

Code
PER-ALB-63
Mercy ID
V-02155-01
Encounter Date
01/26/2006
Last
Peraza
First
Alba
DOB
02/08/1963
County
Gwinnett
Street
61 Oxford Brookway
City
Lawrenceville
State
GA
Zip
30045-
Cell
(770) 572-4006
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Rivas
First
Alvaro
DOB
01/19/1968
Address
N/A
Telephone
N/A
COB
El Salvador
Home Owner
YES
Driver
No
Home Owner
YES
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
Alvaro Rivas Jr 05/21/1991 Mother GA/USA
Andy Rivas 05/12/1997 Mother GA/USA
Jimmy Ramirez 11/25/1985 N/A GA/USA
Lesly Rivas 01/15/1989 Mother GA/USA
Melanie Rivas 06/27/2003 Mother GA/USA
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