PER-ELE-60

Code
PER-ELE-60
Mercy ID
V-00289-01
Encounter Date
09/19/2000
Last
Perez
First
Elena
DOB
09/10/1960
County
Dekalb
Street
3852 Mc Elroy F-2
City
Oraville
State
GA
Zip
30340-
Home
(770) 234-9798
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Vences
First
Eloy
DOB
01/10/1959
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
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
Eloy Vences N/A Grandmother GA/USA
Laura Vences N/A Grandmother GA/USA
Liliam Vences N/A Parents GA/USA
Miguel Vences N/A Grandmother GA/USA
Rocio Vences N/A Grandmother GA/USA
Rosario Vences N/A Grandmother GA/USA
Salvador Vences N/A Grandmother 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
walk in