PAD-LUZ-76

Code
PAD-LUZ-76
Mercy ID
V-03361-01
Encounter Date
07/15/2010
Last
Padilla
First
Luz
DOB
08/29/1976
County
Cobb
Street
1586 Wilewood Road
City
Marietta
State
GA
Zip
30062-
Cell
(678) 886-1625
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Grade school

Spouse Information

Last
N/A
First
N/A
DOB
N/A
Address
N/A
Telephone
N/A
COB
N/A
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
No
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
Edgar Nuñez 03/01/1994 Mother GA/USA
Karina Nuñez 08/26/1999 Mother GA/USA
Luz Celin Ruiz 12/28/2007 Mother GA/USA
Mayra Padilla 11/18/1992 Adulto/Casado GA/USA
Reynaldo Nuñez 03/04/2005 Mother GA/USA

Former Spouse 1 Information

Last
Nuñez
First
Vicente
DOB
12/18/1976
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
linea-Juana