ROD-MAR-82

Code
ROD-MAR-82
Mercy ID
V-02027-01
Encounter Date
12/21/2005
Last
Rodriguez
First
Maria del rosario
DOB
10/02/1982
County
Rockdale
Street
not given
City
Conyers
State
GA
Zip
30012-
Home
(678) 413-2005
Work
(770) 860-1666
Other
(770) 385-1193
Family Status
Single adult
COB
Mexico
Gender
Female
Housing
Shelter
Education Level
Vocational/Technical

Spouse Information

Last
Moreno martinez
First
Daniel
DOB
01/19/1974
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
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
R. Gonzalez
Referred By