MOR-ANA-83

Code
MOR-ANA-83
Mercy ID
V-03393-01
Mother ID
V-03393-01
Encounter Date
08/17/2010
Last
Moreno
First
Ana lilia
DOB
03/19/1983
County
Gwinnett
Street
2272 Newberry Rd.
City
Norcross
State
GA
Zip
30071-
Cell
(770) 255-8503
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Some College

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
YES
Consentimiento De Participar
YES

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
Luis R. Mancilla 04/03/2004 Mother GA/USA

Former Spouse 1 Information

Last
Mancilla
First
Luis
DOB
03/02/1979
Telephone
N/A
COB
Mexico
Home Owner
YES
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
Abogado Ortiz