DAN-ROM-79

Code
DAN-ROM-79
Mercy ID
V-02818-01
Encounter Date
06/12/2008
Last
Dangelo
First
Romina
DOB
10/23/1979
County
Clayton
Street
330 Arrowhead Blvd. #410
City
Jonesboro
State
GA
Zip
30236-
Cell
(770) 603-8787
Other
(770) 210-9066
Family Status
Two parent family w/children
COB
Uruguay
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

Spouse Information

Last
Perez
First
Victor
DOB
11/06/1983
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
Jorgelina Perez 06/20/2004 Parents GA/USA
Rachel Perez 11/07/2005 Parents 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
linea-Griselda