LOP-MAG-85

Code
LOP-MAG-85
Mercy ID
V-03310-01
Encounter Date
04/22/2010
Last
Lopes
First
Magdalena
DOB
10/03/1985
County
Dekalb
Street
1313 Brook Ave.
City
Doraville
State
GA
Zip
30340-
Cell
(678) 600-7094
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
High school graduate

Spouse Information

Last
Reyes
First
Erick
DOB
07/06/1984
Address
N/A
Telephone
N/A
COB
Guatemala
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Angel A Reyes Lopez 09/23/2009 Parents GA/USA
Juan Jesus Rosales 01/07/2006 Mother w/Stepfather GA/USA
Rilly A Rosales 02/28/2008 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
llamo al cell de Griselda