SIE-IVI-72

Code
SIE-IVI-72
Mercy ID
V-03522-01
Encounter Date
02/01/2011
Last
Sierra
First
Ivis
DOB
07/08/1972
County
Cobb
Street
1327 Laura Ln.
City
Austell
State
GA
Zip
30168-
Home
(678) 398-9821
Work
(770) 944-0887
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Single Family
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
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
Ashley Oceguera 06/21/2008 Mother GA/USA
Estefany Rodriguez 08/19/1989 Mother GA/USA
Scarlet Oceguera 11/22/2003 Mother GA/USA

Former Spouse 1 Information

Last
Oceguera
First
Mario
DOB
02/10/1979
Telephone
N/A
COB
Honduras
Home Owner
YES
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/Juana