DEA-NOR-69

Code
DEA-NOR-69
Mercy ID
V-00455-01
Encounter Date
03/22/2001
Last
De avila
First
Nora
DOB
02/01/1969
County
Cobb
Street
410 Mcarhtur Dr.
City
Marietta
State
GA
Zip
30060-
Home
(678) 571-0089
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Orellana
First
Victor
DOB
02/14/1966
Address
same
Telephone
N/A
COB
Belize
Home Owner
YES
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
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
Brenda Orellana 02/21/1994 Parents GA/USA
Diana Orellana 10/11/1998 Parents GA/USA
Ricardo Orellana 11/27/2002 Parents GA/USA
Victor Orellana 06/03/1992 Parents GA/USA
NOTES
Signed consent form and promesa before the fire

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