ORD-ROS-82

Code
ORD-ROS-82
Mercy ID
V-03159-01
Encounter Date
09/08/2009
Last
Orduñez
First
Rosa
DOB
07/01/1982
County
Gwinnett
Street
2106 Preston Lake Dr.
City
Tucker
State
GA
Zip
30084-
Cell
(404) 781-1843
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Arma antonio
First
Jose eduardo
DOB
06/24/1975
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
Andrea Salas 12/01/2007 Mother GA/USA
Genesis Reyes 04/29/2005 Mother GA/USA
Jesus Reyes 05/14/2003 Mother GA/USA

Former Spouse 1 Information

Last
Reyes
First
Eduardo
DOB
07/13/1984
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. Perez
Data Entry
J. Manzo
Referred By
Linea-juana-Holy Cross