ALA-RAQ-01

Code
ALA-RAQ-01
Mercy ID
V-00324-01
Encounter Date
10/15/2000
Last
Alarcon
First
Raquel
DOB
10/05/1972
County
Gwinnett
Street
5537 Rails Way
City
Norcross
State
GA
Zip
30071-
Home
(770) 447-5147
Cell
(404) 934-1482
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Single Family
Education Level
H.S. equivalency diploma

Spouse Information

Last
Rogriguez
First
Wenceslao
DOB
02/14/1971
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
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
Andres Rodriguez 02/19/1998 Mother GA/USA
Karime Rodriguez 12/19/2003 Mother GA/USA
Karina Rodriguez 12/19/2003 Mother GA/USA
Wendy Karen Rodriguez 03/10/1996 Mother GA/USA
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
7764 Ma. Eugenia