RIV-MAR-79

Code
RIV-MAR-79
Mercy ID
V-01687-01
Encounter Date
08/26/2004
Last
Velasco
First
Maricruz
DOB
07/21/1979
County
Gwinnett
Street
5165 Hillcrest Glenn
City
Sugar hill
State
GA
Zip
30518-
Home
(678) 887-5193
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Rivas
First
Miguel A.
DOB
03/17/1976
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
Fabiola Rivas 07/12/1996 N/A Mexico
Jonathan Rivas 03/25/1998 N/A Mexico
Noemi Rivas 11/08/2001 N/A Mexico
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