LOP-AYD-57

Code
LOP-AYD-57
Mercy ID
V-02328-01
Encounter Date
09/13/2006
Last
Lopez
First
Aydee
DOB
02/02/1957
County
Cobb
Street
490 Windy Hill
City
Smyrna
State
GA
Zip
30082-
Home
(404) 454-8977
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Not Homeless

Spouse Information

Last
Alvarez cruz
First
Jorge luis
DOB
N/A
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
YES
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
Client-Zayda Ramirez