HER-LUZ-81

Code
HER-LUZ-81
Mercy ID
V-02928-01
Encounter Date
10/27/2008
Last
Hernandez
First
Luz maria
DOB
01/21/1981
County
Cherokee
Street
120Meadow St. Apt. 120
City
Woodstock
State
GA
Zip
30188-
Other
(678) 445-3458
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Ortega
First
Ricardo
DOB
09/02/1976
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
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
Dayane Hernandez 11/02/2003 Mother GA/USA
Irvin Hernandez 11/09/2004 Mother GA/USA
Kevin Ortega 03/30/1998 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/Mundo Hispano