DIA-VIC-83

Code
DIA-VIC-83
Mercy ID
V-03024-01
Encounter Date
03/09/2009
Last
Diaz
First
Victoria
DOB
10/30/1983
County
Barrow
Street
1061 Fleeman Road
City
Hoschton
State
GA
Zip
30548-
Cell
(404) 484-8654
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Garcia
First
Apolinar
DOB
09/10/1983
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
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
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
Aide S. Garcia 10/25/2007 Parents GA/USA
Fernando Garcia 06/30/2008 Parents GA/USA
Ramiro Garcia 08/10/2001 Parents GA/USA
Rey David Garcia 12/29/2003 Parents GA/USA
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
hermana-Raymunda Diaz