LEO-BEA-83

Code
LEO-BEA-83
Mercy ID
V-03214-01
Encounter Date
11/18/2009
Last
Leon
First
Beatriz
DOB
03/13/1983
County
Clayton
Street
1409 Rockut Road
City
Forest park
State
GA
Zip
30297-
Cell
(404) 293-4841
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade 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
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
YES
Relative
No
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Former Spouse 1 Information

Last
Cortez
First
Jose
DOB
12/25/1983
Telephone
N/A
COB
Mexico
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
C. Collier
Referred By
Consulado de mexico -Liliana