ROD-JUA-76

Code
ROD-JUA-76
Mercy ID
V-00691-01
Encounter Date
09/14/2001
Last
Rodriguez
First
Juana
DOB
09/13/1976
County
Dekalb
Street
1261 Cross Keys Apt. -6
City
Atlanta
State
GA
Zip
30319-
Home
(404) 467-4531
Family Status
Adult coupie-no children
COB
Nicaragua
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Lopez
First
Oscar
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
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
Jamely Rivera 04/20/1994 Grandmother Nicaragua
Jeimy Rivera 04/05/1993 Grandmother Nicaragua
Yendy Rivera 10/04/1995 Grandmother Nicaragua
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
Ma. Eugenia