VAS-JOH-72

Code
VAS-JOH-72
Mercy ID
V-01152-01
Encounter Date
03/14/2003
Last
Vasquez
First
Johana
DOB
04/04/1972
County
Dekalb
Street
3600 Shallowford Rd. Apt. D-7
City
Chamblee
State
GA
Zip
30341-
Home
(678) 698-5982
Family Status
Single parent w/children
COB
Honduras
Gender
Female
Housing
Doubling Up
Education Level
Vocational/Technical

Spouse Information

Last
Lopez-Mejia
First
Leonzo martin
DOB
01/13/1966
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
YES
Consentimiento De Participar
YES

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
No
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
Ivys Melisa Murillo 10/04/1991 Grandmother Honduras
Jorge Julio Murillo 12/22/1994 Mother GA/USA
Katherine Mitchelle Murillo 10/25/1990 Grandmother Honduras
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
x3737 Damaryz