CAN-MAR-80

Code
CAN-MAR-80
Mercy ID
V-01476-01
Encounter Date
01/20/2004
Last
Cantellano
First
Maria de la luz
DOB
07/14/1980
County
Dekalb
Street
64263 Grogran St.
City
Ackworth
State
GA
Zip
30101-
Home
(404) 438-3424
Other
(404) 438-3424
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Transitional
Education Level
High school graduate

Spouse Information

Last
Lopez
First
Joel
DOB
09/10/1980
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
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
Ailyn Lopez 01/17/2002 Parents GA/USA
Jocelyn Lopez 04/13/2001 Parents GA/USA
Joel Cantellano 06/13/2003 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