SAN-ROS-73

Code
SAN-ROS-73
Mercy ID
V-03053-01
Encounter Date
04/01/2009
Last
Sanchez
First
Rosa
DOB
09/22/1973
County
Dekalb
Street
1016 Brookview Ave.
City
Doraville
State
GA
Zip
30340-
Cell
(770) 882-7396
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Sanchez
First
Alejandro
DOB
05/17/1973
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
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
Alejandra Sanchez 08/02/2000 Parents GA/USA
Ivan Sanchez 05/27/2005 Parents GA/USA
Stefany Sanchez 08/29/1998 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
Carolina-Cepta