VEL-JUL-54

Code
VEL-JUL-54
Mercy ID
V-01458-01
Encounter Date
01/05/2004
Last
Velasquez
First
Julia
DOB
07/30/1954
County
Fulton
Street
1479 Raintree Dr. Apt H
City
Roswell
State
GA
Zip
30076-
Home
(770) 643-0185
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Velasquez
First
Rodrigo
DOB
03/19/1960
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
Emma Velasquez 12/06/1983 Adulto/Casado GA/USA
Ruth Velasquez 02/21/1987 N/A Washington
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