LOR-MAR-75

Code
LOR-MAR-75
Mercy ID
V-03143-01
Encounter Date
08/20/2009
Last
Loredo
First
Maria luisa
DOB
05/18/1975
County
Gwinnett
Street
348 Waterberry Dr. # 214
City
Lawrenceville
State
GA
Zip
30045-
Cell
(678) 748-1540
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Flores
First
Luis
DOB
10/21/1979
Address
N/A
Telephone
N/A
COB
El Salvador
Home Owner
YES
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
Antonio Lopez 10/10/1995 Mother w/Stepfather GA/USA
Margarita Lopez 05/18/2000 Mother w/Stepfather GA/USA
Sonia Flores 03/10/2007 Mother w/Stepfather GA/USA

Former Spouse 1 Information

Last
Lopez
First
Antonio
DOB
N/A
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
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana