MEN-RAY-78

Code
MEN-RAY-78
Mercy ID
V-03110-02
Encounter Date
07/07/2009
Last
Mendoza
First
Raymundo
DOB
01/07/1978
County
Dekalb
Street
2181 Dresden Drive
City
Atlanta
State
GA
Zip
30341-
Home
(404) 963-5721
Cell
(678) 500-6535
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Cuevas
First
Herminia
DOB
01/13/1977
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
YES
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
Daysi Cuevas N/A Mother w/Stepfather GA/USA
Raymond Mendoza 02/13/2007 Parents GA/USA
Yesenia Ramirez N/A Mother Mexico
Yusuri Mendoza N/A Mother Mexico

Former Spouse 1 Information

Last
Ruiz
First
Alejandra
DOB
12/11/1982
Telephone
N/A
COB
N/A
Home Owner
No
NOTES

Media Authoritation

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