LOM-LAU-80

Code
LOM-LAU-80
Mercy ID
V-02454-01
Encounter Date
04/04/2007
Last
Lomas
First
Laura
DOB
04/16/1980
County
Fulton
Street
511 Carlton Dr.
City
Palmetto
State
GA
Zip
30268-
Home
(770) 463-8221
Cell
(678) 349-8300
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Lomas
First
Adan
DOB
07/27/1979
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
Adan Isai Lomas 11/08/2004 Mother GA/USA
Jorge Centeno 08/13/1998 Mother GA/USA

Former Spouse 1 Information

Last
Centeno
First
Jorge
DOB
N/A
Telephone
N/A
COB
Mexicano
Home Owner
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
Linea-Juana