DEL-PEN-69

Code
DEL-PEN-69
Mercy ID
V-02378-01
Encounter Date
12/29/2006
Last
De la o torres
First
Penelope
DOB
11/26/1969
County
Gwinnett
Street
724 Jackson Mill Way NW
City
Lilburn
State
GA
Zip
30047-
Home
(770) 807-6677
Cell
(404) 549-1612
Work
(404) 237-2040
Other
(770) 733-0173
Family Status
Two parent family w/children
COB
USA
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

Spouse Information

Last
Torres
First
Sergio
DOB
09/08/1969
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
YES

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
Cristal Hernandez 10/09/1993 Mother w/Stepfather GA/USA
Deny Mendez 08/11/1995 Mother w/Stepfather GA/USA
NOTES
Phone Work Ext. 232

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
Felipe