ROM-LIL-78

Code
ROM-LIL-78
Mercy ID
V-01663-01
Encounter Date
07/12/2004
Last
Romano
First
Liliana
DOB
01/14/1978
County
Gwinnett
Street
335 Dunugan Dr.
City
Lawrenceville
State
GA
Zip
30045-
Home
(770) 243-1234
Cell
(404) 587-7002
Family Status
Adult coupie-no children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
College Degree

Spouse Information

Last
Romano
First
Patrick
DOB
05/13/1966
Address
N/A
Telephone
N/A
COB
EEUU
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
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x1375 Damaryz