VIL-RAQ-78

Code
VIL-RAQ-78
Mercy ID
V-01395-01
Encounter Date
10/29/2003
Last
Villalobos
First
Raquel
DOB
10/25/1978
County
Gwinnett
Street
2248 Shane Pl.
City
Snellville
State
GA
Zip
30078-
Home
(770) 736-6548
Cell
(770) 572-3697
Family Status
Single adult
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
H.S. equivalency diploma

Spouse Information

Last
Fyre
First
Daniel louis
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
YES
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
K. Aleman
Referred By