MOR-KRN-84

Code
MOR-KRN-84
Mercy ID
V-02991-01
Encounter Date
01/23/2009
Last
Moreno
First
Karen
DOB
08/04/1983
County
Dekalb
Street
3630 Shallowford Rd. # K-3
City
Doraville
State
GA
Zip
30340-
Cell
(678) 296-4947
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

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
YES
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
YES
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
Brizeira Moreno 01/15/2005 Grandmother El Salvador - Materna
Jonathan Moreno 02/14/2003 Grandmother El Salvador -Materna
Karen Orocio 04/14/2007 Mother GA/USA
Maria Orocio 08/14/2008 Mother GA/USA

Former Spouse 1 Information

Last
Orocio
First
Federico
DOB
N/A
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
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana