MAL-ROD-02

Code
MAL-ROD-02
Mercy ID
V-02551-02
Encounter Date
04/19/2009
Last
Maldonado
First
Rodrigo
DOB
03/13/1977
County
Cobb
Street
540 Cobb Circle
City
Smyrna
State
GA
Zip
30082-
Cell
(770) 895-4942
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Perez
First
Matilde
DOB
03/14/1979
Address
N/A
Telephone
(770) 895-0023
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
YES
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
David Maldonado 03/11/2000 Parents GA/USA
Lisandro Maldonado 01/20/2002 Parents GA/USA
Milton Maldonado 05/02/2006 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
Compañera/Linea-Juana