CRU-ROC-69

Code
CRU-ROC-69
Mercy ID
V-01302-01
Encounter Date
08/05/2003
Last
Cruz
First
Rocio
DOB
10/06/1969
County
Fulton
Street
201 Northwood Dr. M-2
City
Atlanta
State
GA
Zip
30342-
Home
(678) 886-1920
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Vasquez
First
Santiago
DOB
08/06/1969
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Diego Vasquez 11/13/1992 Parents GA/USA
Jerry Vasquez 05/23/1998 Parents GA/USA
Jose Julian Vasquez 08/02/2001 Parents GA/USA
Lucero Vasquez 11/11/1988 Parents GA/USA
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