CRU-EPI-68

Code
CRU-EPI-68
Mercy ID
V-03089-01
Encounter Date
06/03/2009
Last
Cruz
First
Epifania
DOB
01/21/1968
County
Gwinnett
Street
2725 Fortapachee Tr.
City
Dacula
State
GA
Zip
30019-
Cell
(404) 503-6361
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
Cerezo
First
Pablo
DOB
07/15/1964
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
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
Abigail Cerezo 08/25/2004 Parents GA/USA
David Cerezo 05/22/2000 Parents GA/USA
Eugenio Cerezo 12/19/1994 Parents GA/USA
Mauricio Cerezo 05/22/1993 Parents GA/USA
Rosa Cerezo 07/13/2002 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
TV-amiga vio anuncio