MOR-VER-82

Code
MOR-VER-82
Mercy ID
V-03333-01
Encounter Date
05/27/2010
Last
Morales
First
Veronica
DOB
12/03/1982
County
Gwinnett
Street
4295 Placent Lake # B
City
Norcross
State
GA
Zip
30044-
Cell
(678) 755-9972
Family Status
Single parent w/children
COB
Guatemala
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

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
No
Consentimiento De Participar
No

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
Elersy Patzan 09/23/2004 Mother GA/USA
Jenny Patzan 10/31/2006 Mother GA/USA
Joab Fuentes 11/11/2008 Mother GA/USA

Former Spouse 1 Information

Last
Patzan
First
Abner
DOB
N/A
Telephone
N/A
COB
Guatemala
Home Owner
YES
NOTES

Media Authoritation

NO 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