CAR-GEN-69

Code
CAR-GEN-69
Mercy ID
V-02877-02
Encounter Date
10/21/2008
Last
Cardenas
First
Genaro
DOB
02/21/1969
County
Fulton
Street
1540 Vassar Ave. SW
City
College park
State
GA
Zip
30337-
Cell
(770) 891-1259
Family Status
Single adult
COB
Mexico
Gender
Male
Housing
Other
Education Level
Grade school

Spouse Information

Last
Sanchez
First
Laticia
DOB
06/16/1972
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
YES
Program Completed
YES
DFCS Mandated
No
Alcohol & Drug
YES
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
YES
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
Ana maria Cardenas 07/22/2001 Mother GA/USA
Citlali Elena Cardenas 01/26/2000 Mother GA/USA
Mario Alberto Cardenas 09/18/1992 Mother GA/USA

Former Spouse 1 Information

Last
Sanchez
First
Leticia
DOB
06/16/1972
Telephone
N/A
COB
N/A
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
linea-Juana