FLO-HOR-61

Code
FLO-HOR-61
Mercy ID
V-00669-01
Encounter Date
09/05/2001
Last
Flores
First
Hormides
DOB
04/28/1961
County
Dekalb
Street
1378 N. Cliff Valley Way #G-6
City
Atlanta
State
GA
Zip
30319-
Home
(404) 486-0956
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Flores
First
Antonio
DOB
08/18/1948
Address
N/A
Telephone
N/A
COB
Mexico
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
Alejandro 09/27/1992 Mother GA/USA
Azucena 04/24/1997 Mother GA/USA
Jasmin 12/28/1990 Mother GA/USA
Jose Antonio 04/15/1985 Mother GA/USA
Margarita 02/29/1984 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
K. Aleman
Referred By