ROS-CRI-79

Code
ROS-CRI-79
Mercy ID
V-03042-01
Encounter Date
04/13/2009
Last
Rosas
First
Cristina
DOB
07/25/1979
County
Fulton
Street
66 Northwood Dr. Apt. 105
City
Atlanta
State
GA
Zip
30342-
Cell
(678) 301-8411
Other
(404) 725-7099
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Fuentes
First
Mario
DOB
06/16/1973
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
YES
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
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
Christopher Fuentes 04/04/2008 Parents GA/USA
Mario A. Fuentes 05/29/2004 Parents GA/USA
Yaniret A. Herrera 04/29/1993 Grandparents Maternos
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana