ESC-COR-73

Code
ESC-COR-73
Mercy ID
V-00841-01
Encounter Date
02/12/2002
Last
Escobar
First
Coritza
DOB
06/29/1973
County
Dekalb
Street
3683 Buford Hwy Apt. 9
City
Atlanta
State
GA
Zip
30329-
Home
(404) 471-1862
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Lopez
First
Martin
DOB
01/13/1966
Address
N/A
Telephone
N/A
COB
Mexico
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
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Axely Yasmar Lopez 01/09/2001 Mother GA/USA
Kevin Ketzel Lopez 09/22/1994 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
x7764 Ma. Eugenia