MEN-CEC-59

Code
MEN-CEC-59
Mercy ID
V-00239-01
Encounter Date
03/02/2001
Last
Delgado
First
Cecilia
DOB
06/04/1959
County
Fulton
Street
990 Old Holcom Bridge Road
City
Roswell
State
GA
Zip
30076-
Cell
(678) 914-9096
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
Some College

Spouse Information

Last
Delgado
First
Jose
DOB
N/A
Address
N/A
Telephone
N/A
COB
Cuba
Home Owner
YES
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
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
aleen 12/09/1987 Parents GA/USA
arian 12/09/1997 Parents GA/USA
sergio alfonso 05/25/1986 Parents GA/USA

Former Spouse 1 Information

Last
Viveros-Salinas
First
Alfonso luis
DOB
02/25/1956
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
S. Aviña
Referred By
Linea-Juana/Univision