MON-ROS-72

Code
MON-ROS-72
Mercy ID
V-02781-01
Encounter Date
05/12/2008
Last
Mondragon
First
Rosa
DOB
01/20/1972
County
Gwinnett
Street
4498 Buford Hwy
City
Norcross
State
GA
Zip
30071-
Cell
(770) 837-5956
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Garcia
First
Jorge
DOB
05/06/1973
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
YES
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
Akira Garcia 08/09/1994 Mother GA/USA
Gwyneth Garcia 04/15/1993 Mother GA/USA
Jail Garcia 01/06/2000 Mother GA/USA
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
linea-Juana