Code
LOP-MAR-68
Mercy ID
V-00184-01
Encounter Date
04/18/2000
Last
Lopez
First
Maria
DOB
06/28/1968
County
Cobb
Street
949 Shilon Ridge Run NW
City
Kennesaw
State
GA
Zip
30144-
Home
(770) 429-3881
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Garay
First
Jorge
DOB
04/23/1971
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
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Jorge Garay 09/29/1994 Parents GA/USA
Marcela Garay 01/12/1999 Parents 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
D. Gomez
Referred By