ROD-NOE-76

Code
ROD-NOE-76
Mercy ID
V-03160-01
Encounter Date
09/01/2009
Last
Rodriguez
First
Noemi
DOB
08/15/1976
County
Cobb
Street
48 Oxford Rd.
City
Marietta
State
GA
Zip
30008-
Cell
(678) 334-3663
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
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
YES
Consentimiento De Participar
YES

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
Francis Rodriguez 03/10/1995 Mother GA/USA
Jasmin Tello 10/10/1993 Mother GA/USA

Former Spouse 1 Information

Last
Rodriguez
First
Moises
DOB
05/17/1974
Telephone
N/A
COB
N/A
Home Owner
YES
NOTES

Media Authoritation

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