SAN-DOL-77

Code
SAN-DOL-77
Mercy ID
V-03470-01
Encounter Date
10/26/2010
Last
Santos
First
Dolores
DOB
07/28/1977
County
Gwinnett
Street
3355 Sweetwater Rd. Apt. 8108
City
Lawrenceville
State
GA
Zip
30044-
Cell
(678) 663-4843
Family Status
Single parent w/children
COB
Dominican Rep
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
YES
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
Alberto Araujo 04/22/1998 Mother GA/USA
Kenneth Alvarez 07/16/2004 Mother GA/USA
Lietza Rodriguez 01/19/1996 Grandmother D. R. - Materna

Former Spouse 1 Information

Last
Reyes
First
Alexis
DOB
N/A
Telephone
N/A
COB
USA
Home Owner
YES
NOTES

Media Authoritation

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