FER-ANG-75

Code
FER-ANG-75
Mercy ID
V-00394-01
Encounter Date
01/24/2001
Last
Fernandez
First
Angelica
DOB
06/28/1975
County
Dekalb
Street
2612 Mclave Rd.
City
Doraville
State
GA
Zip
30340-
Home
(404) 247-0401
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
College Degree

Spouse Information

Last
Olmedo
First
Edgar
Middle
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
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
Juan Daniel Acevedo 02/12/1997 Grandmother Colombia
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
K. Aleman
Referred By
North Medical Health Center