LOR-ROS-72

Code
LOR-ROS-72
Mercy ID
V-03334-01
Encounter Date
05/26/2010
Last
Lorenzo
First
Rosalba
DOB
09/14/1972
County
Dekalb
Street
2095 Burton Plaza lane Apt. H-4
City
Atlanta
State
GA
Zip
30319-
Cell
(404) 838-9508
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Santos
First
Ismael
DOB
07/04/1984
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
Flor Santos 05/02/2008 Parents GA/USA
Francisco Rumualdo 02/06/1999 Aunt Mexico-Paterna
Kevib Rumualdo 06/19/2001 Aunt Mexico-Paterna
Luis M. Morales 08/09/1990 Grandmother Mexico-Paterna
Paloma C. Morales 09/13/1989 Adulto/Casado GA/USA
Surena Rumualdo 09/25/1995 Aunt mexico-Paterna

Former Spouse 1 Information

Last
Rumualdo
First
Francisco
DOB
08/30/1970
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

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