URI-CAT-70

Code
URI-CAT-70
Mercy ID
V-01830-01
Encounter Date
02/08/2005
Last
Uriostegui
First
Catalina
DOB
04/30/1970
County
Cobb
Street
2350 Cobb Parkway Apt. 17-H
City
Smyrna
State
GA
Zip
30080-
Home
(770) 984-2673
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Vocational/Technical

Spouse Information

Last
Antunez
First
Nemesio
DOB
10/31/1970
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
YES
Consentimiento De Participar
YES

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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Israel Antunez 12/25/1995 Parents GA/USA
Oscar Antunez 04/28/1994 Parents GA/USA
Virginia Uriostegui 11/12/1996 Parents GA/USA
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
Camen Benitez/Family Ties