ROS-NOR-72

Code
ROS-NOR-72
Mercy ID
V-02638-01
Encounter Date
11/09/2007
Last
Morales
First
Nora
DOB
05/03/1972
County
Gwinnett
Street
4305 Paxton Lane Apt, I-51
City
Lilburn
State
GA
Zip
30047-
Cell
(678) 558-2055
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
YES
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
Angelo Diaz 07/28/2000 Mother GA/USA

Former Spouse 1 Information

Last
Diaz
First
Angelo
DOB
04/10/1980
Telephone
N/A
COB
USA
Home Owner
YES
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