BAR-YES-80

Code
BAR-YES-80
Mercy ID
V-03072-01
Encounter Date
05/13/2009
Last
Barajas
First
Yesenia
DOB
02/07/1980
County
Clayton
Street
6355 Valley Dale Road
City
Riverdale
State
GA
Zip
30274-
Cell
(678) 368-6568
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Villalobos
First
Hugo
DOB
05/07/1980
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
YES
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
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
Brayan Cervantes 10/20/2002 Mother w/Stepfather GA/USA
Kevin Villalobos 06/26/2008 Parents GA/USA

Former Spouse 1 Information

Last
Cervantes
First
Roberto
DOB
09/22/1973
Telephone
N/A
COB
N/A
Home Owner
YES
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
walk in