RAM-MOI-70

Code
RAM-MOI-70
Mercy ID
V-03477-02
Encounter Date
11/30/2010
Last
Ramirez
First
Moises
DOB
01/28/1970
County
Gwinnett
Street
1149 Guernsey Dr.
City
Lawrenceville
State
GA
Zip
30043-
Home
(770) 339-1735
Cell
(770) 318-0038
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Single Family
Education Level
some high school

Spouse Information

Last
Ramirez
First
Francisca
DOB
07/15/1971
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
YES
Gwinnett
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
YES
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
Angelica Ramirez 04/06/2002 Parents GA/USA
Cindy M. Ramirez 02/21/1991 Parents GA/USA
Johana Ramirez 05/05/1995 Aunt GA/USA
Kathy Ramirez 01/11/1999 Parents GA/USA
Moises A. Ramirez 01/16/1993 Parents GA/USA
NOTES
STAY AWAY cond. Para la hija Johana que esta en DFCS

Media Authoritation

NO DOY PERMISO
DOY PERMISO
YES
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
J. Manzo
Referred By
DFCS/Linea-Juana