Code
POL-VIC-73
Mercy ID
V-01882-01
Encounter Date
04/11/2005
Last
Bello
First
Victoria
DOB
08/21/1973
County
Dekalb
Street
2287 Plaster Rd. #7
City
Atlanta
State
GA
Zip
30345-
Home
(404) 399-7238
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Preschool

Spouse Information

Last
Polanco
First
Freddy
DOB
11/09/1972
Address
N/A
Telephone
N/A
COB
Guatemala
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
YES
Consentimiento De Participar
YES

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

Children

NAME DOB LIVING WITH STATE/COUNTRY
Charile Chiche 09/27/1999 Mother GA/USA
Jesus Bello 03/01/1992 Grandmother Mexico
Lesly Bello 02/25/1997 Mother GA/USA
Suleima Bello 10/26/1989 Mother GA/USA
NOTES

Media Authoritation

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