CUA-LIN-70

Code
CUA-LIN-70
Mercy ID
V-03013-01
Encounter Date
02/25/2009
Last
Cuadrado
First
Lina
DOB
05/03/1970
County
Gwinnett
Street
2728 Northwood Ln
City
Duluth
State
GA
Zip
30096-
Cell
(678) 598-1546
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Single Family
Education Level
College Degree

Spouse Information

Last
Lopez
First
Javier
DOB
N/A
Address
N/A
Telephone
N/A
COB
Colombia
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
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
Hernan J. Lopez 12/27/2000 Parents GA/USA
Stefany Lopez 06/17/2005 Parents GA/USA

Former Spouse 1 Information

Last
Inojosa
First
Ricardo
DOB
N/A
Telephone
N/A
COB
N/A
Home Owner
No
NOTES

Media Authoritation

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