COR-JES-79

Code
COR-JES-79
Mercy ID
V-01763-02
Encounter Date
12/07/2004
Last
Cortina gomez
First
Jesus arturo
DOB
12/15/1979
County
Fulton
Street
4689 Roswell Rd. Apt L8
City
Atlanta
State
GA
Zip
30342-
Home
(404) 303-0153
Cell
(770) 455-1119
Family Status
Two parent family w/children
COB
Mexico
Gender
Male
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Tapia
First
Cristina
DOB
02/19/1978
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
SOLO
No
Court Mandated
No
Program Completed
YES
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
Cindel Tapia 10/23/1995 Parents GA/USA
Jose Mojica Tapia 09/27/1994 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
R. Miranda
Data Entry
K. Aleman
Referred By
Fulton