Code
COR-ELI-70
Mercy ID
B-00018-02
Encounter Date
07/03/1998
Last
Cortes
First
Eliseo
DOB
06/14/1970
County
Other
Street
not given
City
Not given
State
GA
Zip
00000-000
Home
(770) 992-6359
Family Status
Adult coupie-no children
COB
Mexico
Gender
Male
Housing
Other
Education Level
Other

Spouse Information

Last
Acosta
First
Maria
DOB
07/07/1959
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
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No
NOTES

Media Authoritation

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