LOP-MAG-75

Code
LOP-MAG-75
Mercy ID
V-00198-01
Encounter Date
05/10/2000
Last
Lopez
First
Magaly
DOB
07/18/1975
County
Dekalb
Street
774 South Hairston Rd.
City
Stone mountain
State
GA
Zip
30088-
Home
(404) 378-6412
Cell
(678) 754-2082
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Olivo
First
Antonio
DOB
05/21/1971
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
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
Edrey Lopez 11/06/1994 Mother GA/USA
Esteban Garcia 12/02/2002 Parents GA/USA
Sheilla Jalithzy Olivo 10/11/1995 Mother GA/USA

Former Spouse 1 Information

Last
Olivo
First
Antonio
DOB
05/17/1971
Telephone
N/A
COB
822 Columbia Dr. Dec
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
D. Gomez
Referred By