LOP-PAU-60

Code
LOP-PAU-60
Mercy ID
V-00229-01
Encounter Date
05/30/2000
Last
Lopez
First
Paula
DOB
01/15/1960
County
Dekalb
Street
3635 Morningsite Ln
City
Doraville
State
GA
Zip
30340-
Home
(678) 406-9622
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
some high school

Spouse Information

Last
Velazquez
First
Agustin
DOB
07/04/1973
Address
7275 Roswell Rd -4 !59 Atlanta ga 30328
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
No
Consentimiento De Participar
No

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
Natalia Velazquez 05/18/1997 Grandmother GA/USA
Tania Velazquez 07/23/1982 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
D. Gomez
Referred By