FER-ANG-27

Code
FER-ANG-27
Mercy ID
V-01027-01
Encounter Date
11/05/2002
Last
Fernandez
First
Angelica
DOB
09/03/1975
County
Dekalb
Street
2285 Plaster Rd.
City
Chamblee
State
GA
Zip
30345-
Home
(404) 417-9851
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Robles
First
Carlos
DOB
11/02/1971
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
Angel 12/08/2000 Parents GA/USA
Carlos Alexix Robles 04/17/1992 Parents GA/USA
Melissa 07/08/1998 Parents 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
Peggy