LOP-DUL-71

Code
LOP-DUL-71
Mercy ID
V-00208-01
Encounter Date
05/12/2000
Last
Lopez
First
Dulce
DOB
08/22/1971
County
Dekalb
Street
2731 shallowford #d rd
City
Chamblee
State
GA
Zip
30341-
Home
(770) 986-9069
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Gonzales
First
Rogelio
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
ernesto daniel gonzales 11/07/1990 Grandparents GA/USA
jose de jesus 09/23/1997 Grandparents GA/USA
rogelio adan 02/06/1995 Grandparents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
S. Aviña
Referred By