ROS-DIO-78

Code
ROS-DIO-78
Mercy ID
V-03244-01
Encounter Date
01/27/2010
Last
Rosado
First
Diodelvina
DOB
09/15/1978
County
Dekalb
Street
1382 Northcliff Valley Way #-H
City
Atlanta
State
GA
Zip
30319-
Home
(404) 321-1840
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Mena
First
Gustavo
Middle
08
DOB
08/29/1973
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
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Dorly Mena Rosado 03/04/2005 Parents GA/USA
Irlanda Mena Rosado 06/11/2007 Parents GA/USA
NOTES

Media Authoritation

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