HUA-RIT-64

Code
HUA-RIT-64
Mercy ID
V-03287-01
Encounter Date
03/08/2010
Last
Huaca
First
Rita
DOB
09/05/1964
County
Gwinnett
Street
2212 Westford Dr. NW
City
Norcross
State
GA
Zip
30071-
Cell
(678) 698-5231
Family Status
Single parent w/children
COB
Ecuador
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Raines
First
Hebert
DOB
03/27/1963
Address
N/A
Telephone
N/A
COB
USA
Home Owner
YES
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
David Parra 08/24/2001 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
LINEA-Juana