SAN-ERI-82

Code
SAN-ERI-82
Mercy ID
V-02187-01
Encounter Date
03/01/2006
Last
Sandoval
First
Erica
DOB
04/23/1982
County
Gwinnett
Street
3768 Elmside Dr. # B
City
Norcross
State
GA
Zip
30092-
Home
(678) 577-1865
Cell
(678) 668-5960
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Ramirez
First
Ismael
DOB
01/14/1981
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
Brytan Ramirez 08/06/2004 Parents GA/USA
Keyla Ramirez 07/27/2006 Parents GA/USA
Mirian Ramirez 04/26/2002 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By
Rafael Miranda