LOR-MAR-55

Code
LOR-MAR-55
Mercy ID
V-02313-01
Encounter Date
08/23/2006
Last
Lores
First
Maria
DOB
09/08/1955
County
Dekalb
Street
2350 Idlewood Ln.
City
Tucker
State
GA
Zip
30084-
Home
(678) 933-4671
Family Status
Single parent w/children
COB
Cuba
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Perez
First
Pablo
DOB
N/A
Address
N/A
Telephone
N/A
COB
Cuba
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
Yadira Bolaños 08/31/1989 Mother 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
J. Manzo
Referred By