OCH-IRM-62

Code
OCH-IRM-62
Mercy ID
V-03464-01
Encounter Date
11/02/2010
Last
Ochoa
First
Irma
DOB
01/02/1962
County
Fulton
Street
3064 Larose St.
City
East point
State
GA
Zip
30344-
Cell
(404) 552-5044
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

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
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
Jesus A. Sanchez 05/10/1993 Mother GA/USA
Joselyn Sanchez 08/06/1997 Mother GA/USA
Leonel Sanchez 03/27/2003 Mother GA/USA

Former Spouse 1 Information

Last
Sanchez
First
Leonel
DOB
02/03/1964
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Griselda