PAL-LUZ-55

Code
PAL-LUZ-55
Mercy ID
V-00428-01
Encounter Date
02/27/2001
Last
Palecio
First
Luz maria
DOB
10/09/1955
County
Cobb
Street
3761 laurel green rd
City
Aculorth
State
GA
Zip
30101-
Home
(770) 529-1062
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Not Homeless
Education Level
Child, not in school

Spouse Information

Last
Reyna
First
Miguel
DOB
06/13/1951
Address
N/A
Telephone
N/A
COB
Colombia
Home Owner
No
Driver
No
Home Owner
YES
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
Jenny Reyna 04/04/1975 N/A GA/USA
July Reyna 12/31/1981 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
D. Gomez
Referred By
jack melendez