CRU-NOE-69

Code
CRU-NOE-69
Mercy ID
V-02693-01
Encounter Date
01/17/2008
Last
Cruz
First
Noemi
DOB
01/08/1969
County
Cobb
Street
2405 Chauncey Lane
City
Marietta
State
GA
Zip
30064-
Home
(770) 726-7430
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
H.S. equivalency diploma

Spouse Information

Last
N/A
First
N/A
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
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Alejandra Bedolla 07/17/1987 Mother GA/USA
Edna Bedolla 06/06/1988 Mother GA/USA
Jennifer Sanchez 01/24/1994 Mother GA/USA
Luis Bedolla 03/23/1991 Mother GA/USA

Former Spouse 1 Information

Last
Bedolla
First
Luis
DOB
05/05/1967
Telephone
N/A
COB
Mexico
Home Owner
No
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