CAR-LOR-76

Code
CAR-LOR-76
Mercy ID
V-02988-01
Encounter Date
01/15/2009
Last
Carmona
First
Lorena
DOB
05/15/1976
County
Clayton
Street
1147 Evelyn Dr.
City
Forest park
State
GA
Zip
30297-
Home
(404) 228-7206
Cell
(404) 751-8741
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
YES
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
Amanda Lugo 06/15/2006 Mother GA/USA
Chris Lugo 11/20/2003 Mother GA/USA
Josue Acuna 09/03/1996 Mother GA/USA

Former Spouse 1 Information

Last
Lugo
First
Carlos
DOB
08/26/2007
Telephone
N/A
COB
N/A
Home Owner
YES
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-Juana