MOR-CRI-73

Code
MOR-CRI-73
Mercy ID
V-03463-01
Encounter Date
11/05/2010
Last
Morales
First
Cristina
DOB
12/05/1973
County
Fulton
Street
832 Parkridge Lane Cr. Apt. B
City
Roswell
State
GA
Zip
30076-
Cell
(404) 732-2232
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

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
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
Eleasar Hernandez 10/23/2003 Mother GA/USA
Eunice Hernandez 07/17/2007 Mother GA/USA
Irais Hernandez 11/17/2000 Mother GA/USA
Jesabel Hernandez 10/28/1998 Mother GA/USA

Former Spouse 1 Information

Last
Hernandez
First
Jose luis
DOB
07/17/1971
Telephone
N/A
COB
N/A
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 de informacion