CAM-ROS-73

Code
CAM-ROS-73
Mercy ID
V-01143-01
Encounter Date
03/11/2003
Last
Campos
First
Rosa idalia
DOB
03/09/1973
County
Dekalb
Street
1355 Graves Rd. Apt 04-89
City
Norcross
State
GA
Zip
30093-
Home
(404) 292-1539
Family Status
Single parent w/children
COB
El Salvador
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Blanco rivera
First
Zacarias
Middle
12057
DOB
12/05/1975
Address
N/A
Telephone
N/A
COB
El Salvador
Home Owner
YES
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
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
Brian Alonso Merino 08/30/1994 Mother GA/USA
Kimberly Nohemi Merino 06/13/1996 Mother GA/USA
Luis Antony Merino 12/19/1991 Parents GA/USA
Zacarias Emilio Blanco 02/01/2003 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
Mision Catolica