HER-VIC-70

Code
HER-VIC-70
Mercy ID
V-00182-02
Encounter Date
04/13/2000
Last
Herrera
First
Victor
DOB
11/12/1970
County
Fulton
Street
5801 King Sport Dr Apt-136
City
Atlanta
State
GA
Zip
30342-
Home
(770) 480-5298
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Petatan
First
Diega
DOB
11/14/1965
Address
same
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
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
claudia herrera 11/11/1991 N/A GA/USA
victor herrera 07/05/1990 N/A GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
D. Gomez
Referred By