MOR-SIR-86

Code
MOR-SIR-86
Mercy ID
V-03485-01
Encounter Date
12/10/2010
Last
Moreno
First
Siria
DOB
11/24/1986
County
Gwinnett
Street
5777 Candlewick Lane
City
Lilburn
State
GA
Zip
30047-
Cell
(404) 454-4881
Family Status
Single adult
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
YES
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
Alejandra Melero 08/25/2003 DFACS Gwinnett
Brianna Melero 01/14/2010 DFACS Gwinnett
Daylyn Melero 03/27/2007 DFACS Gwinnett
Francisco Melero 09/12/2005 DFACS Gwinnett

Former Spouse 1 Information

Last
Melero
First
Francisco
DOB
07/29/1981
Telephone
N/A
COB
Mexico
Home Owner
No
NOTES

Media Authoritation

NO 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