REY-MAR-99

Code
REY-MAR-99
Mercy ID
V-02401-01
Encounter Date
01/30/2007
Last
Reyes
First
Maria elena
DOB
01/01/2022
County
Not given
Street
not given
City
No se
State
GA
Zip
99999-9999
Home
(999) 999-9999
Family Status
Single parent w/children
COB
Mexico
Gender
Female

Spouse Information

Last
Fuentes
First
Jose
DOB
10/22/1973
Address
2836 Landington Way Duluth, GA 30096
Telephone
(678) 978-8571
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
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
Daniel Fuentes N/A Mother GA/USA
Enrique Fuentes N/A Mother GA/USA
Guadalupe Fuentes N/A Mother GA/USA
Jose Fuentes N/A Mother GA/USA
NOTES
****NO SE PUDO CONTACTAR A LA Sra. Y SE LE HIZO ENTREVISTA AL SR.****

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