CRU-ALI-74

Code
CRU-ALI-74
Mercy ID
V-02701-01
Encounter Date
01/23/2008
Last
Cruz
First
Alicia
DOB
12/28/1974
County
Gwinnett
Street
1374 Country Downs Drive
City
Norcross
State
GA
Zip
30093-
Cell
(678) 789-2906
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Delgado
First
Azael
DOB
05/16/1975
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
YES
Consentimiento De Participar
YES

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
Arlette Delgado 05/17/2001 Mother GA/USA
Fernando Delgado 10/10/2002 Mother GA/USA
Johan Delgado 08/30/2004 Mother GA/USA
Mariam Delgado 05/17/2001 Mother GA/USA
Sweel Delgado 10/19/1998 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