CAR-PAT-75

Code
CAR-PAT-75
Mercy ID
V-00325-01
Encounter Date
10/30/2000
Last
Carrisales
First
Patricia
DOB
02/13/1975
County
Dekalb
Street
1150 Rankie st
City
Stone
State
GA
Zip
30083-
Home
(678) 457-0644
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Street
Education Level
some high school

Spouse Information

Last
Arreola
First
Moises
Middle
A.
DOB
09/04/1975
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
Eduardo Arreola 10/23/1992 Mother GA/USA
Mariana Arreola 06/01/1991 Mother GA/USA
Moises Arreola 03/24/1995 Mother 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
7764 Rebeca