VAZ-NIN-74

Code
VAZ-NIN-74
Mercy ID
V-00537-01
Encounter Date
06/01/2001
Last
Vazquez
First
Ninosca
DOB
02/05/1974
County
Dekalb
Street
4900 Central Ave. Apt. 159
City
Stone mountain
State
GA
Zip
30083-
Home
(770) 469-8124
Family Status
Single parent w/children
COB
Nicaragua
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Rojas
First
Rene
DOB
N/A
Address
N/A
Telephone
N/A
COB
El Salvador
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
Tonya Lizbeth Vasquez 10/14/1996 Mother GA/USA
William Antonio Avilez 10/31/1994 Mother 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
K. Aleman
Referred By
Jerry and Mitchell x7764