VEL-LET-81

Code
VEL-LET-81
Mercy ID
V-03232-01
Encounter Date
01/05/2010
Last
Velazco
First
Leticia
DOB
04/07/1981
County
Gwinnett
Street
3113 Northwoods
City
Duluth
State
GA
Zip
30096-
Cell
(706) 220-7709
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
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
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
Emily Puerta 10/03/2004 Mother GA/USA
Lisbeth Perez 10/29/1998 Mother GA/USA
Yessica Velazco 10/08/2001 Mother GA/USA

Former Spouse 1 Information

Last
Puerta
First
Tomas
DOB
11/02/1979
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
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Griselda