RIO-MAR-80

Code
RIO-MAR-80
Mercy ID
V-03371-01
Encounter Date
07/27/2010
Last
Rios
First
Maria de los angeles
DOB
08/02/1980
County
Gwinnett
Street
2724 Ridgebrook Trail
City
Duluth
State
GA
Zip
30096-
Other
(678) 748-0435
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Adult, no formal education

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
Christian Castrejon 12/08/2008 Mother GA/USA
Jaiy Rios 10/31/2003 Mother GA/USA
Jose G. Rios 11/02/2006 Mother GA/USA

Former Spouse 1 Information

Last
Castrejon
First
Javier
DOB
12/22/1978
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
Pilar & linea