ABR-ARA-75

Code
ABR-ARA-75
Mercy ID
V-02462-01
Encounter Date
04/02/2007
Last
Camacho
First
Felix
DOB
09/14/1975
County
Cobb
Street
not given
City
Smyrna
State
GA
Zip
30080-
Cell
(678) 651-7337
Other
(404) 396-5992
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Street
Education Level
Grade school

Spouse Information

Last
Mendoza
First
J. Carmen
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
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
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Carlos Mendoza 12/03/1995 Mother GA/USA
Desired Mendoza 09/05/1993 Mother GA/USA
Francisco Mendoza 08/25/1996 Mother GA/USA
Manuel Mendoza 01/15/1991 Mother GA/USA
Ricardo Mendoza 11/09/1998 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
Linea-Juana