MOR-JOH-85

Code
MOR-JOH-85
Mercy ID
V-02480-01
Encounter Date
05/04/2007
Last
Morales
First
Johanna
DOB
08/01/1985
County
Clayton
Street
4701 Beecher Rd.
City
Forest park
State
GA
Zip
30000-
Cell
(404) 641-1844
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Rodriguez
First
Juan
DOB
02/12/1986
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
Geisha Sanchez 08/21/2004 Mother GA/USA

Former Spouse 1 Information

Last
Sanchez
First
Noe
DOB
N/A
Telephone
N/A
COB
N/A
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
Selene Lopez-Secure House Clayton