RAM-LET-74

Code
RAM-LET-74
Mercy ID
V-03237-01
Encounter Date
01/13/2010
Last
Ramos
First
Leticia
DOB
12/09/1974
County
Cobb
Street
1794 James Dr.
City
Marietta
State
GA
Zip
30060-
Cell
(770) 709-1658
Work
(678) 508-2669
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
YES
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
Edgar Javier Flores Ramos 06/19/1991 Father Mexico
Jonathan Javier Reyes 07/09/1988 Grandmother Materna GA
Jose Angel Gustavo Toral Ramos 11/06/2001 Mother GA/USA
Sael Rodriguez Ramos 06/15/2009 Mother GA/USA

Former Spouse 1 Information

Last
Rodriguez
First
Sael
DOB
01/02/1980
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
C. Martinez
Data Entry
J. Manzo
Referred By
Walk in